Newsroom, a media outlet that lists as its "partners" the likes of Bell Gully, Universities of Auckland, Otago and Victoria, is running a prominent article today with the heading:
"Bribery & punishment rarely work to incentivize good behavior, so John Key should put down the wooden spoon about vaccine-hesitant people .. When I read [him] suggesting 'incentives' (offering a mix of material 'rewards' for getting vaccinated & sanctions for not) should make up a core part of our vaccination strategy .. I rolled my eyes".
To answer such questions on the role of incentivizing "good behavior", decent economists head for studies that have been properly done. Like the one written by the winners of the 2019 Nobel Prize in Economics, Esther Duflo, and Adhijit Banerjee, who both work at the Massachusetts Institute of Technology. Their life-long aim has been to improve the health outcomes of the poor, living in countries like India.
Duflo & Banerjee's best-known study, in the British Medical Journal, is on the topic of "Improving Immunization Coverage in Rural India: A Clustered Randomized Controlled Evaluation of Immunization Campaigns with and without Incentives". The Nobel Citation specifically referred to this particular article.
What did Duflo & Banerjee discover? "That offering modest incentives to families in resource poor settings can significantly increase uptake of immunisation services". What was the "incentive", or "bribe", or "material reward"? "Parents were offered 1 kg of raw lentils per immunisation administered and a set of thalis (metal plates used for meals) on completion of a child’s full immunisation. The value of the lentils was about 40 rupees (about $1), equivalent to three quarters of one day’s wage, and the value of the thalis was about 75 rupees".
In a policy implication devastating to the Newsroom article, the authors say "providing incentives & improving the supply of services was also more cost effective than improving the supply of services alone". Those "services" refer to mobile immunization teams, the equivalent of our vaccination buses.
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