Nonmonetary Commodity Incentives in Family Planning Programs: A Preliminary Trial

Abstract

A variety of incentive schemes has been proposed to improve the effectiveness of family planning programs. In general the few that have been tried have been limited to monetary or cash incentives. Monetary reimbursement to workers has perhaps been the form of incentive payment most widely used. Family planning workers in South Korea Taiwan India and Pakistan have been at least partially reimbursed for patient referrals or for service. Finders fees have been offered in Egypt India Pakistan and Taiwan to encourage satisfied patients or other ambitious members of the community who refer clients for family planning. Taiwan has experimented successfully with coupons offering free IUD insertions for a limited time. In the Taiwan experiment the increase in patient recruitment more than offset the loss of income to the program and cost per acceptor dropped during the period of free insertion. With the exception of Taiwans free insertion coupon patient incentives have usually been limited to small cash payments given to acceptors ostensibly to cover transportation costs to the clinic (Pakistan) or as compensation for loss of time from work (India). It is generally agreed that a cash incentive offered to worker or patient will increase at least temporarily the number of patient acceptances. It is also agreed that incentives can be abused particularly if they are viewed as a substitute for adequate patient information or care. This report deals with a type of non-monetary incentive widely used in commercial sales promotion campaigns. The commodity incentive may be defined as the offer of goods or merchandise of a recognized commercial value as a reward for taking a specific action within a given time period or as a reward for achievement in a given undertaking. In Ghana it was decided to evaluate the effectiveness of a simple commodity incentive in increasing the proportion of referred women who came to the clinic for service. In the preliminary trial a commodity that would have both a real and a symbolic value was selected. Whole powdered milk was chosen as it met both these requirements. The product selected was commercially available throughout the country and had a known value. The powdered milk was also selected for the symbolic value to demonstrate to the mothers that family planning would help themselves and their children to a better life. (excerpt)