Non-Incentivized Service Spillover Effect

In Simple Words

Paying a worker a targeted fee to visit a specific house (such as a mother who just had a baby) opens the door for a general relationship. Once inside, the worker naturally provides additional non-paid care (like checking on a sick child) because building trust and goodwill increases overall community demand for the worker's broader services.

Research question

Policy makers often fear that paying targeted bonuses for specific healthcare tasks will cause workers to neglect non-paid routine health duties or erode intrinsic prosocial motivation.

Participants

~7,000 households in 214 villages (115 treatment, 99 comparison) in rural Uganda.

Study Design

Randomized Controlled Trial (RCT) comparing rates of incentivized postnatal visits ($0.65 payment) against non-incentivized follow-up visits for child illness (malaria/diarrhea).

Results

Households in treatment villages saw an 8.1 percentage point increase (71% increase from 11.4% baseline) in incentivized newborn visits and a concurrent 6.1 percentage point increase (73% increase from 8.4% baseline) in non-incentivized sick-child follow-up visits.

Takeaway

Design targeted financial micro-incentives for high-priority maternal and neonatal visits without restricting health promoters from delivering general non-incentivized primary consultation during the same visit.

Read alongside the research

Plain-English glossary

Original explanations, informed by the references below. Examples are illustrations, not data from the studies above. The research text stays unchanged.

Percentage points

The difference between two percentages.

ExampleA rise from 40% to 50% is 10 percentage points. Relative to the starting value, that is a 25% increase.

Office for National Statistics · Percentages ↗Read more about percentage points →

Randomized controlled trial

A study that uses chance, like drawing lots, to decide who receives each option being compared. Researchers compare the groups’ outcomes to estimate the effect of those options.

ExampleA lottery assigns volunteers to a training programme or a comparison group. Researchers then compare their outcomes.

GET-IT glossary · Randomized study ↗Read more about randomized controlled trial →

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