Social Incentives for the First Malaria Vaccine in Sierra Leone
Country: Sierra Leone
Duration: 2 years
Amount: $1,163,463
Problem
Malaria is the leading cause of child mortality in Sierra Leone, accounting for 25% of deaths in children under five (around 6,800 young lives lost every year).
A new four-dose malaria vaccine has been introduced, but ensuring children receive all doses is challenging – only 56% of children in Sierra Leone complete their routine immunizations. Many children start vaccines but never finish the series, leaving them vulnerable.
Caregivers often lack incentives or reminders to return for all doses. Without full vaccination, children remain at high risk of malaria, and the country misses out on the vaccine’s life-saving potential.
Approach
Innovative Incentive: This project will evaluate whether providing a simple reward – in this case, colorful bracelets given to caregivers – can motivate families to complete all four vaccine visits. The bracelets serve as a visible symbol of participation and encouragement to return.
Scale of Trial: The study will reach 133,000 children, testing two variations of the bracelet incentive to see which most effectively encourages caregivers to bring children for every dose. By comparing outcomes, the project will identify a cost-effective way to increase full vaccination rates.
Strong Partnerships: The program is implemented in partnership with Sierra Leone’s Ministry of Health, building on an existing collaborative platform. This close government involvement means successful strategies can be adopted nationally. Researchers from Innovations for Poverty Action (IPA) and the University of Chicago are helping design and evaluate the approach, and they are already engaging other countries like Liberia and Nigeria in case of success. This groundwork lays the foundation for broader scale-up across the region in the next decade.
Path to Scale
The program has strong national scale-up potential, building on a longstanding partnership with Sierra Leone’s Ministry of Health, existing evidence of effectiveness and existing government buy-in for bracelets in Sierra Leone.
The IPA and UChicago teams are already working on building public sector interest in scaling the intervention in Liberia or Nigeria, with strong potential to scale in the next 10 years.
Why we think the grant is cost-effective
An earlier experiment by the same group showed bracelets to be comparable to the most cost-effective interventions for increasing uptake of childhood vaccinations. Leading evaluator Innovations for Poverty Action calls it a “best bet.”
The intervention is estimated to cost $30 per additional child fully vaccinated against malaria and $4,603 per child death averted.
If the trial results are strong, the low unit cost and existing government buy-in mean Sierra Leone could integrate the incentive into routine vaccination nationwide. Neighboring countries with similar challenges could also replicate the model, leveraging the evidence and Sierra Leone’s example to save thousands of children’s lives.