Giving What We Can no longer conducts our own research into charities and cause areas. Instead, we're relying on the work of organisations including J-PAL, GiveWell, and the Open Philanthropy Project, which are in a better position to provide more comprehensive research coverage.
These research reports represent our thinking as of late 2016, and much of the information will be relevant for making decisions about how to donate as effectively as possible. However we are not updating them and the information may therefore be out of date.
Economic empowerment; development; children; maternal Health
New Incentives was founded in 2011. It provides conditional cash transfers for women with HIV or at-risk pregnancies working in partnership with the Ministry of Health in Nigeria. They provide transfers up to about $150 over the course of the program. The transfers are conditional on the mother registering her pregnancy and being tested for HIV, delivering in a clinic, and (if HIV-positive) having their newborns tested for HIV. The program started by only focusing on mother-to-child HIV transmission. However, New Incentives found it would not be feasible to scale its operations by only focusing on prevention of mother to child transmission (PMTCT). It thus expanded its program as to also include at-risk pregnancies, to be able to work in smaller clinics which work with fewer HIV-positive woman. Risk factors include anemia, hepatitis, old age, young age, tuberculosis, and previous non-facility births.
New Incentives is a very promising charity. As we note above, conditional cash transfers are widely-studied and effective programs and they have been shown to increase antenatal visits, skilled attendance at birth and deliveries in health facilities. Prevention of mother to child transmission is an highly effective area and New Incentives has demonstrated to be highly committed to transparency.
Prevention of mother to child transmission of HIV is an highly cost effective intervention. The estimate of the Disease Control Priorities (DCP) is that using a single dose of nevirapine (the simplest program) costs $6-$12 per disability-adjusted life year (DALY) averted. Nevirapine decreases the amount of HIV in the blood, decreasing the risk of transmission. GiveWell estimates this is equivalent to $150-$300 per HIV infection averted. In Nigeria, where New Incentive’s program takes place, the infant regime for prevention of mother-to-child transmission also includes a six-week supply of nevirapine to take home and administer to their babies daily. This supply is estimated to cost about $11 more per newborn.
The global rate of stillbirths was estimated to be 18.9 per 1000 births in 2009, which means a total of 2.64 million stillbirths, 1.2 million of which were during labour. 98% of stillbirths occur in low and middle income countries. Recently, UNICEF and the World Health Organization coordinated the Every Newborn action plan, which aims to provide all nations with a platform for ending preventable newborn deaths. Some of the interventions aimed decreasing stillbirths and neonatal deaths are highly cost-effective. For instance, a recent study suggests the incremental cost/DALY averted of syphilis screening is $53 in Asia and $60 in Latin America. With respect to the program focusing on at-risk pregnancies, New Incentives estimates it is expected to save a life for approximately $5.000-$10.000.
As we note above, evidence shows conditional cash transfers lead to increased spending among recipients, largely on food. Research also indicates that cash transfers can benefit recipients via investment and savings. The Centre for Global Development recently conducted a systematic review of studies that report maternal and newborn health outcomes. They find that CCTs have increased antenatal visits, skilled attendance at birth, delivery at a health facility, and tetanus toxoid vaccination for mothers, and reduced the incidence of low birth weight. It should be stressed that evidence also suggests low birth weight correlates to lower IQ and academic achievement later in life. However, they find impact on maternal and newborn mortality has not been well documented so far. New Incentives is currently running a randomised control trial and expects results will be available in summer 2017.
New Incentives was founded in 2011 thanks to a donation from the Lampert Family Foundation. It has received donations from Good Ventures, the Bill & Melinda Gates Foundation, and REG Charity.
New Incentives estimates it will need $867,000 in for its programs 2016, of which $570,000 for CCT and $295,000 for administrative costs. It had $127,000 to allocate to programs as of February 2016, it expected to run out of funding at the end of March/beginning of April. New Incentives estimates a funding gap of $705,000 to support its operations from April to December 2016.