Impact Evaluation on Improving Voluntary Medical Male Circumcision Demand in Malawi through the Use of Incentives

World Bank

World Bank, Washington, DC

关键词: CIRCUMCISION;    INCENTIVE SCHEME;    IMPACT EVALUATION;    SOCIAL NETWORKS;    HEALTH SERVICES;   

RP-ID  :  125668

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

This report presents an impactevaluation assessing the effect of incentives on improvingthe uptake of Voluntary Medical Male Circumcision (VMMC) intwo districts in Malawi. The cluster randomised controltrial was led by the National AIDS Commission of Malawi andimplemented from December 2015 to April 2016. The primaryresearch question was whether incentives can increase VMMCuptake among in-school and out-of-school males aged 10-34.Collective incentives (e.g. whiteboards, football equipment)to schools and Mothers’ Groups, as well as individualincentives in the form of vouchers for VMMC were tested. Theevaluation found that incentives in the form of vouchers forVMMC work. The vouchers had a significant positive impact onVMMC demand by increasing the odds of getting circumcised byover seven times. Secondary distribution by voucherrecipients showed potential to informally increasedistribution networks without increasing costs. There wassome evidence of spill-over to relatives: nearly a third ofparticipants in both study districts who had been givenvouchers reported that they gave vouchers to relatives.Using the participants’ own social networks had the resultof expanding the reach of the intervention withoutadditional distribution costs. The evaluation also foundthat community-involvement, especially in the form ofMothers’ Groups, was essential to motivate young men to seekVMMC. The report discusses the policy implications of thispositive finding of incentives.