Interactive Research and Development
Conditional Cash Transfers | Karachi, Pakistan | Test & Transition
The development problem: According to the WHO, an estimated 18.7 million infants worldwide were not reached with routine immunization services in 2014. A particular problem is the decrease in immunization rates throughout the duration of the immunization programme. In many countries, higher immunization rates early in infancy dip significantly by the end of the immunisation schedule. Studies indicate that in Pakistan alone, an estimated 9-13 million children under the age of 2 have not received age-appropriate immunization coverage.
The innovation: Prior research suggests that small incentives for parents can increase full immunization rates six-fold. Interactive Research and Development will seek to find the most cost-effective policy for delivering such small ‘nudges’, by testing the effectiveness of different amounts and pay-out mechanisms.
GIF’s investment: With this investment, GIF is supporting Interactive Research and Development to carry out a three-year randomized controlled trial. The study will occur in a context where it has the potential to be integrated into long-term government programs: within an existing immunization programme that uses a phone-based electronic registry for childhood immunisations in Karachi, Pakistan. The registry has been linked to an interactive SMS messaging system and to electronic mobile money transfers, which would be used to deliver SMS reminders and small cash transfers to parents.
Why we invested:
- This well-designed RCT addresses an important public health challenge with significant potential benefits on child mortality and morbidity.
- A strong local team, with extensive technical expertise, positive track record, and good relations with local and national governments.
- Strong support from funders of immunization programmes (notably NORAD), strong additionality to current efforts in Pakistan, and initial political support of key Pakistani health officials.
- Potential to address both financial and logistical scale up constraints to immunization programmes.