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Increasing Community Health Worker Motivation Using Probabilistic Incentives

In low and middle income countries (LMICs) the shortage of physicians and nurses together with generally poor health practices pose significant public health risks.

In this setting, it has been shown that community health workers (CHWs) can provide cost effective preventive care, leading to policy-makers identifying this approach as a solution to achieving public health objectives in the UN SDGs. Despite this, the economic well-being of CHWs is often overlooked.

CHWs either volunteer their service or are paid token honorariums for their services making this approach cost effective. However these status-quo arrangements also pose significant risks to the sustainable human capacity of health systems for two reasons: (a) high turnover rate of staff (e.g., 15-20% annually in our partner NGO’s operations), and (b) significant variability across CHWs’ performance, which is partially driven by a lack of effort and motivation.

These inefficiencies lead to poor healthcare outcomes in communities and pose challenges to the operations of healthcare providing NGOs in LMICs.

In this project, academics from RMIT University, Monash University and Duke University are teaming up with BRAC International to run a Randomised Control Trial (RCT) to test the efficacy of various incentive schemes in stabilizing health systems.