The problem: Low immunization rates
Childhood vaccines prevent an estimated 2 to 3 million deaths every year [1]. They are recognized as one of the most cost-effective child health interventions in low-income countries. Yet, in 2019, an estimated 14 million infants around the world were still not reached by vaccination services[2]. The problem of low immunization rates is especially clear and pressing in Nigeria. Nigeria is home to just 2.6% of the world’s population [3], yet it accounts for 16% of the world’s mortality of children under five [4]. As of 2019, Nigeria had the highest mortality rate in the world among children under five years [5](117 deaths per 1,000 live births)[6]. Strikingly, an estimated 40% of under-five deaths in Nigeria are from vaccine-preventable diseases [7]. North West Nigeria specifically has the highest under-five mortality rate in the country. It also has the lowest vaccination coverage in the country, with only around one quarter of the infants getting fully immunized, leaving a large population of infants vulnerable to disease outbreaks[8].
The problem of low vaccination coverage in Nigeria is further exacerbated by extreme poverty. This is especially true in North West Nigeria, where many mothers live on less than US$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. Many of them 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 [9].
The solution: Conditional cash transfers (CCTs)
Conditional cash transfer programmes (CCTs) give money to low-income households in return for fulfilling specific behavioral 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, who can make their own choices as to how to spend or save this money.
New Incentives is a pioneer in a growing movement committed to providing small incentives to caregivers whose infants get immunized while also increasing awareness of the overall health benefits of childhood vaccinations. They offer cash transfers to caregivers who vaccinate their infants after verifying that their infant has gotten the latest vaccinations. New Incentives distributes a total of around US$11 for each infant — enough to cover transport, medicine, and food for their families [10] — across five separate cash transfers (disbursed over five separate visits to the clinic in the first year of the infant’s life).
