Afya Credits Incentive for Improved Maternal and Child Health Outcomes in Kenya

Caroline Ochieng of the Stockholm Environment Institute in Sweden is evaluating an approach to stimulate women in Kenya to regularly visit health clinics during pregnancy and after birth to improve maternal health. Currently, the majority visits only once, and infant and maternal mortality are high. To encourage the women to keep additional appointments they will give them a health credit voucher that can be exchanged for a specific cash amount or retained for a subsequent appointment, for up to four appointments, when they receive another voucher worth twice as much. In Phase I, they enrolled 200 women in a county in Kenya to test the reward scheme, with preliminary results showing 90% went to a second appointment. In Phase II, Stacey Noel, also of the Stockholm Environment Institute in Sweden, will scale up the test to 3600 women across 18 health facilities, and prolong the award scheme to one year after birth, as a way to also promote infant health. They will also analyze the cost-effectiveness of the scheme, and its effect on health by conducting a cluster randomized control trial.