Home  -  How It works

How It Works

Our Model

New Incentives runs a conditional cash transfer (CCT) program in North West Nigeria (Jigawa, Katsina, Zamfara) which disburses cash incentives to caregivers conditional on infants receiving four vaccines: BCG (against tuberculosis), PENTA (against diphtheria, tetanus, whooping cough, hepatitis B and Haemophilus influenzae type b), PCV (against pneumococcal disease), and MCV (against measles). These vaccinations are part of the routine schedule for infant immunizations in Nigeria and are provided at no cost to the caregiver through government supported clinics.

By incentivizing these four vaccines (BCG, PENTA, PCV, MCV), New Incentives is able to indirectly promote all vaccines that are part of the routine immunization schedule in Nigeria.

240,000+
Infants enrolled
in the program
930,000+
Cash transfers issued after verifying vaccination
90.58%
Retention rate through immunization cycle

Program Activities Supported by New Incentives

Verify infants have received the appropriate vaccinations (condition) and disburse the predefined cash transfer
Raise awareness of the benefits of vaccination and increase demand for immunization services
Improve vaccine supply by identifying and addressing bottlenecks in the vaccine supply chain

Conditional Cash Transfer Process

Conditional cash transfer programmes (CCTs) give money to low-income households in return for fulfilling specific behavioural conditions. These conditions include for example children's school attendance, up-to-date vaccinations or regular visits to a health care facility by pregnant women. CCTs have a direct effect on poverty by providing an immediate additional income for the poor. They can make their own choices as to how to spend or save this money. (Source)

New Incentives is a pioneer in a growing movement of giving small incentives to caregivers whose infants get immunized, while increasing awareness of the health benefits of childhood vaccinations.

At Birth, or as close as possible
BCG  OPV 0  Hep B
₦500
6 weeks
PENTA 1    PCV 1    OPV 1
₦500
10 weeks
PENTA 2   PCV 2   OPV 2
₦500
14 weeks
PENTA 3   PCV 3   IPV
₦500
9 months
Measles   Yellow Fever
₦2,000
01
Zamfara
02
Katsina
03
Jigawa

The program is conducted with the approval of and in close collaboration with the Governments of Katsina, Zamfara and Jigawa State in North West Nigeria. According to the 2018 Nigeria Demographic and Health Survey, North West Nigeria is the region with the lowest vaccination coverage in Nigeria with only around one quarter of the infants getting fully immunized, leaving a large population of infants vulnerable to disease outbreaks.

Impact

Frequently Asked Questions

01
1
HOW DOES YOUR PROGRAM WORK IN DETAIL?

Many mothers in North West Nigeria live on less than $2 a day and cannot visit the clinic for various reasons. They face challenges such as affording the transportation cost to the clinic, associated loss in earnings from small-scale trading or farming, receiving permission from their partners, fear of vaccination side effects, cultural barriers to vaccination, or often a combination of these factors. We provide cash transfers to caregivers who vaccinate their infants after verifying that their infant has gotten the latest vaccinations. The five transfers given during five visits to the clinic in the first year of the infant’s life totals ~USD $11, enough to cover transport, medicine, and food for their families.

02
2
WHY IS THIS PROGRAM IMPORTANT?

Poor mothers in rural West Africa are stuck in a cycle of poverty. Living at the bottom of the economic ladder forces them to make choices between their survival today and a better future for them and their children tomorrow. Your donation and cash transfer give them a chance to escape from this vicious cycle: they do not have to worry about missing work and can afford transport to access health clinics. Put simply, they no longer have to choose between food today or health tomorrow. The impact is profound: children are protected against deadly diseases. A Randomized Controlled Trial (RCT) is evaluating the impact of our program.

03
3
What is a Randomized Controlled Trial and why does it matter?

A Randomized controlled trial or RCT is a study in which people are allocated at random (by chance alone) to receive an intervention so that the results can be compared with a control group. This matters because the impact of a program is often a complex interaction of circumstances and effects with unknown externalities, a RCT can help dissociate this to help establish a causal effect of the intervention. It helps organizations assess what their work actually does and does not do.

04
4
HOW IS NEW INCENTIVES DIFFERENT THAN TRADITIONAL AID?

New Incentives focuses on using evidence-based methods to make programmatic decisions and to do the most good possible. Some examples of how we do this: we designed our program to use Conditional Cash Transfers, an approach that has been proven to be effective in changing health behaviors; we focus on immunizations and operate in North West Nigeria, where only around 25% of infants are fully immunized thus leading to devastating disease outbreaks; and we take operational decisions internally based on data to increase program effectiveness.

05
5
HOW IS THIS DIFFERENT FROM MICROFINANCE?

Conditional cash transfers are different from microloans. Conditional cash transfers are not loans, meaning the recipient does not have to repay the transfer amount and is not subject to a cycle of debt.

06
6
WHERE IN WEST AFRICA DO YOU OPERATE?

New Incentives operates where it can have the biggest impact: rural Nigeria. The West African country is home to just 3% of the world’s population, yet accounts for 13% of the world’s mortality of children under five, the second highest rate in the world.

07
7
ARE DONATIONS TO NEW INCENTIVES TAX-EXEMPT?

Yes. Donations to New Incentives made in the USA are tax-exempt under section 501(c)(3) of the Internal Revenue Code. Contact us if you'd like to donate from outside the US.

09
9
HOW DOES NEW INCENTIVES PREVENT FRAUD?

Fraud mitigation and preventing potential leakage of funds is one of our core responsibilities. We have comprehensive procedures and systems to prevent and detect fraud. We carry out post-transfer reviews of each disbursement, regularly perform unannounced program audits, and have robust data analytics that we continuously iterate based on lessons learned. We follow rigorous standards for recruiting, training, and managing our personnel.

010
10
HOW DOES NEW INCENTIVES SUPPORT VACCINE SUPPLY?

New Incentives encourages timely vaccination recordkeeping and reporting, review of vaccine stock to help prevent vaccine stockouts, and provides support to government stakeholders to submit vaccine utilization reports. To assess vaccine quality, we work with clinic staff to review vaccine vial monitors (VVMs), vaccine expiry dates, and call Local Cold Chain Officers (LCCOs) and State Cold Chain Officers (SCCOs) every other week to verify the stock and validity of vaccine supply. A documented review of availability of adequate stock is completed before each immunization day. Issues are resolved prior to the start of the session when escalated. Stockouts that occur during the session are also reported and efforts are made to resolve before the next session. Our teams work with LCCOs and SCCOs to assess availability of adequate vaccines in stock for the next two weeks.

01
1
HOW DOES YOUR PROGRAM WORK IN DETAIL?

Many mothers in North West Nigeria live on less than $2 a day and cannot visit the clinic for various reasons. They face challenges such as affording the transportation cost to the clinic, associated loss in earnings from small-scale trading or farming, receiving permission from their partners, fear of vaccination side effects, cultural barriers to vaccination, or often a combination of these factors. We provide cash transfers to caregivers who vaccinate their infants after verifying that their infant has gotten the latest vaccinations. The five transfers given during five visits to the clinic in the first year of the infant’s life totals ~USD $11, enough to cover transport, medicine, and food for their families.

02
2
WHY IS THIS PROGRAM IMPORTANT?

Poor mothers in rural West Africa are stuck in a cycle of poverty. Living at the bottom of the economic ladder forces them to make choices between their survival today and a better future for them and their children tomorrow. Your donation and cash transfer give them a chance to escape from this vicious cycle: they do not have to worry about missing work and can afford transport to access health clinics. Put simply, they no longer have to choose between food today or health tomorrow. The impact is profound: children are protected against deadly diseases. A Randomized Controlled Trial (RCT) is evaluating the impact of our program.

03
3
What is a Randomized Controlled Trial and why does it matter?

A Randomized controlled trial or RCT is a study in which people are allocated at random (by chance alone) to receive an intervention so that the results can be compared with a control group. This matters because the impact of a program is often a complex interaction of circumstances and effects with unknown externalities, a RCT can help dissociate this to help establish a causal effect of the intervention. It helps organizations assess what their work actually does and does not do.

04
4
HOW IS NEW INCENTIVES DIFFERENT THAN TRADITIONAL AID?

New Incentives focuses on using evidence-based methods to make programmatic decisions and to do the most good possible. Some examples of how we do this: we designed our program to use Conditional Cash Transfers, an approach that has been proven to be effective in changing health behaviors; we focus on immunizations and operate in North West Nigeria, where only around 25% of infants are fully immunized thus leading to devastating disease outbreaks; and we take operational decisions internally based on data to increase program effectiveness.

05
5
HOW IS THIS DIFFERENT FROM MICROFINANCE?

Conditional cash transfers are different from microloans. Conditional cash transfers are not loans, meaning the recipient does not have to repay the transfer amount and is not subject to a cycle of debt.

06
6
WHERE IN WEST AFRICA DO YOU OPERATE?

New Incentives operates where it can have the biggest impact: rural Nigeria. The West African country is home to just 3% of the world’s population, yet accounts for 13% of the world’s mortality of children under five, the second highest rate in the world.

07
7
ARE DONATIONS TO NEW INCENTIVES TAX-EXEMPT?

Yes. Donations to New Incentives made in the USA are tax-exempt under section 501(c)(3) of the Internal Revenue Code. Contact us if you'd like to donate from outside the US.

09
9
HOW DOES NEW INCENTIVES PREVENT FRAUD?

Fraud mitigation and preventing potential leakage of funds is one of our core responsibilities. We have comprehensive procedures and systems to prevent and detect fraud. We carry out post-transfer reviews of each disbursement, regularly perform unannounced program audits, and have robust data analytics that we continuously iterate based on lessons learned. We follow rigorous standards for recruiting, training, and managing our personnel.

010
10
HOW DOES NEW INCENTIVES SUPPORT VACCINE SUPPLY?

New Incentives encourages timely vaccination recordkeeping and reporting, review of vaccine stock to help prevent vaccine stockouts, and provides support to government stakeholders to submit vaccine utilization reports. To assess vaccine quality, we work with clinic staff to review vaccine vial monitors (VVMs), vaccine expiry dates, and call Local Cold Chain Officers (LCCOs) and State Cold Chain Officers (SCCOs) every other week to verify the stock and validity of vaccine supply. A documented review of availability of adequate stock is completed before each immunization day. Issues are resolved prior to the start of the session when escalated. Stockouts that occur during the session are also reported and efforts are made to resolve before the next session. Our teams work with LCCOs and SCCOs to assess availability of adequate vaccines in stock for the next two weeks.

011
11
DOES NEW INCENTIVES SUPPORT THE ROUTINE IMMUNIZATION SYSTEM OUTSIDE OF CASH TRANSFERS?

New Incentives actively participates at the State Emergency Routine Immunization Coordination Centre (SERICC) and has provided financial and technical supports such ass: Training of LGA Routine Immunization Officers, printing of data tools and materials for outreach with traditional leaders, support for SERICC infrastructure, collaboration with private clinics on Routine Immunizations, participation in supportive supervision, and quarterly earmarked financial support to SERICC on their choice of activities that strengthen routine immunization.

Randomized Controlled Trial

Expected in Dec 2020

Study with two-arm cluster RCT

- Control (83 clinics): No intervention, status quo

- Treatment (84 clinics): New Incentives full program

- This design will measure the causal effect of New Incentives' program on the likelihood of an infant receiving vaccinations.

Pre-Analysis Plan

New Incentives offers conditional cash transfers (CCTs) to incentivize infant vaccination in North West Nigeria. There is strong evidence that expanding vaccination reduces illness and death among young children. CCTs could plausibly be a cost-effective way to increase vaccination rates among children in areas like North West Nigeria where vaccine supply is adequate but uptake is low.

Nancy Birdsall

Founding President / Center for Global Development

I think Conditional Cash Transfer programs are as close as you can come to a magic bullet in development. They are creating an incentive for families to invest in their own children’s futures. Every decade or so, we see something that can really make a difference, and this is one of those things.

Research

New Incentives' program was developed based on the high-quality body of rigorous evidence supporting conditional cash transfers (CCTs). The following links contain particularly insightful research on CCTs.

Impact of CCTs on Maternal and Newborn Health

GiveWell Review of Cash Transfers

World Bank

CCTs have been remarkable in a variety of ways. One of those ways is that perhaps more than any intervention in developing countries, CCTs have been evaluated credibly for their impact on a variety of outcomes—consumption, labor market participation, poverty, nutritional status, and schooling to name but a few. (Source)