The grant recognizes the success of the Afya pilot study, which led to health workers for the first time achieving and exceeding service demand targets set by the Ministry of Health and County health management teams.

With funding from the Gates Foundation, SEI and its partners will scale up the study from 200 women to 3,600 women, thus covering all pregnant women and their infants across 18 health facilities in Siaya District over a 24-month period.

Caroline Ochieng, SEI Research Fellow and project leader said, “At a minimum, the project will have a significant direct impact on the health of 7200 individuals who are the mother-child pairs we will enrol.”

Building on lessons learned

The success of the pilot study not only demonstrated that the payments were highly effective in ensuring continuity of health visits from pregnancy to post-natal period, but also that the cash transfer approach can effect positive behaviour change. The scheme also showed the acceptability of this type of incentive in the region, and has laid scientific and policy groundwork for testing and scaling up personal financial incentives as a means to tackle hard-to-change behaviours that significantly impact on maternal and child health in Kenya.

The second phase will provide an opportunity for testing the feasibility of the scheme at a much larger scale. While the first phase entailed manual recording of health visits, the second phase will partner with businesses in Kenya’s well-developed ICT and mobile banking sectors to design and implement an electronic system for logging the health visits and transferring cash to recipients.

A model scheme for other governments and development organizations

The project staff hopes that the scheme will serve as model for further uptake by governments all over Africa and major donors across the continent.

“Since 2009, the Government of Kenya has been implementing the Cash Transfer for Orphans and Vulnerable Children (CT-OVC) programme”, noted Ochieng. “At the end of the project we hope that we can convince them to extend this type of programme to also cover pregnant women using this type of intervention.”