Leveraging Rotating Savings and Credit Associations (ROSCAs) for Innovation in Demand Generation

Erika Linnander of Yale University in the U.S. will use the social influence of rotating savings and credit associations (ROSCAs) – groups who save and borrow together– to increase demand for routine immunizations in Cameroon and Ethiopia. Both these countries have lower than average vaccination coverage and high levels of ROSCA participation. ROSCAs, associations whose members contribute to a fund that can be paid out in whole or in part to each member in rotation, are a savings vehicle for those who may not have access to formal financial institutions. They are also an important part of community structure; it is estimated that 50-95% of adults in parts of Africa belong to at least one. Invitation to join is a signal of belonging and the associations yield powerful social influence also on health behavior. They will develop a program to leverage this influence to increase routine immunization coverage for children. They will locate three ROSCAs in each country in areas with poor coverage and work with local innovators using a human-centered design approach to develop and test ways to increase demand for immunization. Success will be evaluated by changes to member knowledge of and attitudes toward immunization and increased demand.