Two of our former UC Berkeley students recently published new findings that describe how people in Tanzania use the incentives they receive in exchange for engaging in beneficial health behaviors. In a qualitative study led by Dr. Nancy Czaicki and published in AIDS Care, our team found that people living with HIV who received monthly cash or food assistance when they visited the HIV clinic reported myriad beneficial effects on household welfare. Participants reported that incentives were predominantly used for food, school fees, and investing in businesses. There were no reports of harmful events associated with the incentives. In a second qualitative study published in Social Science & Medicine, Dr. Jan Cooper examined how female sex workers in Dar es Salaam changed their behavior in order to receive a cash transfer conditional on staying free of sexually transmitted infections. Although many of the women had limited ability to insist on condom use with sexual partners, they reported substantial power over their work logistics, such as reducing the number of workdays and clients, that they leveraged to meet the conditions of the incentive program. This is an important new finding that adds to what we know about how incentives help women achieve health goals. Together, these studies add to the growing evidence base about the benefits of cash and other kinds of incentives for improving health and welfare in sub-Saharan Africa.
Our team is thrilled to announce the results of our randomized trial comparing the effectiveness of conditional cash and food transfers to improve adherence to antiretroviral therapy and retention in HIV care among adults in Tanzania. The study found that both food assistance and cash transfers increased adherence to treatment and reduced loss to follow-up, although cash transfers were more effective than food assistance after the incentive period was over. We also found that cash transfers cost less than food transfers, are easier to implement, and are often preferred by patients. The presentation at AIDS 2016 (Durban, South Africa) can be viewed here and the results are available starting January 2017 in the journal AIDS. The study was a collaboration between UC Berkeley, the Shinyanga Regional Medical Office, and the Ministry of Health, Community Development, Gender, Elderly, and Children. It was funded by the U.S. National Institutes of Health.
Read a short report about nutritional support provided by the World Food Programme (WFP) to AIDS-affected and other vulnerable families in Zimbabwe. After nutritional assessment, clients at local clinics meeting the criteria for assistance are referred to WFP and their implementing partners and receive Super Cereal, a nutritious fortified blend of maize meal, soya protein and micronutrients. They also get a monthly household ration of maize meal, vegetable oil and pulses. Some types of food assistance programs, similar to this one in Zimbabwe, have been shown to increase adherence to antiretroviral therapy among people living with HIV infection. Read more about WFP's HIV/AIDS-related programs here.