New Incentives will implement conditional cash transfers that directly impact 1,000 ultra-poor pregnant women and 1,000 newborns in southern Nigeria for 12 to 18 consecutive months, depending on the specific needs of each woman. The Healthy Moms, Healthy Babies: Safe Motherhood Alliance will achieve the following goals: 1) promote financial inclusion through access to capital; 2) increase utilization of prenatal health services; 3) ensure delivery with skilled birth attendants; and 4) promote improved community and household cultural norms and attitudes towards the health of pregnant women and newborns. This will enable the population of pregnant mothers included in the program to ensure the safe delivery of their children and will decrease the likelihood of maternal death without risking starvation or sacrificing other essential expenditures for their household. To ensure the success of the program, New Incentives will provide transfers in communities where the Nigerian government and institutional donors have previously carried out supply-side interventions that have increased health resources, commodities, and medications. New Incentives will target women in these communities who aren't utilizing these solutions due to barriers to access.
To fulfill this commitment, New Incentives will call upon the experience of successfully completing its pilot conditional cash transfer programs in four countries. Relevant programs achieved significant positive health outcomes including increases in immunizations, utilization of health services, and nutrition. New Incentives will work with a local implementing partner, Excellence Community Education Welfare Scheme (ECEWS), which has a history of community-based leadership and years of experience working with ultra-poor pregnant women. New Incentives will leverage the volunteer-run nature of ECEWS to conduct focus groups with youth leaders, community elders, and other local stakeholders (known as Community Leadership Teams) when identifying beneficiaries, determining method of disbursement, and designing the conditions behind each cash transfer. New Incentives will also work with ECEWS to develop systems for routine data collection from local health centers. New Incentives will raise all funds for the Healthy Moms, Healthy Babies: Safe Motherhood Alliance. On a monthly basis, New Incentives will make conditional cash transfers to target pregnant women according to outcomes shown in health data.
New Incentives will roll out the conditional cash transfer program with four cohorts of 250 women that are spaced three months apart. The first cohort will be brought into the program in January 2013, the second cohort in April 2013, the third cohort in July 2013, and the fourth cohort in October 2013.
The following four steps will be followed for each cohort in the first five months of their participation:
Month One: New Incentives will secure funding to implement the conditional cash transfer program for 250 eligible pregnant women. New Incentives will also elicit the relevant support of key stakeholders necessary for proper implementation of the transfer program.
Month Two: ECEWS will communicate the purpose, values, duration, and relevant information of the conditional cash transfer program to communities and potential households. ECEWS will then conduct focus groups in the field with Community Leadership Teams to identify and select 250 eligible pregnant women. This process ensures that community and household buy-in is attained. At the end of each phase, community action committees will be formed that consist of volunteers who will perform monitoring in their respective villages during the program.
Month Three: ECEWS will conduct focus groups with target pregnant women to determine the most appropriate conditions behind the transfers. The transfers will vary on a monthly basis, and will include HIV testing, utilization of prenatal services, and delivery with a skilled birth attendant. Other conditions might include receiving critical immunizations and birth certificates for newborns. Making conditional cash transfers to women and engaging them in the process of determining which conditions need to be met increases their bargaining power.
Month Four: New Incentives and ECEWS will set up data collection systems with associated human capital indicator institution (e.g., if human capital indicator is prenatal checkups, the associated institution is a health center).
Month Five: New Incentives will initiate monthly transfers.
In addition, on a monthly basis, New Incentives and ECEWS will collect associated human capital investment indicator data and disburse monthly transfers according to health outcomes. Beneficiaries will be eligible to receive transfers for up to 18 months, depending on the needs of each target woman's household. On a quarterly basis, New Incentives will report the success or failure of monthly conditional cash transfers and related outcomes back to donors and key stakeholders.
Nigeria, one of the most resource rich and populous countries in Africa, suffers from deep resource inequality and extreme poverty. Nigeria is responsible for approximately 30 percent of the global burden of mother-to-child transmission of HIV. A significant number of newborns are at risk of contracting HIV from infected mothers who deliver infants with untrained traditional birth attendants. Nigeria alone constitutes 32 percent of the 'gap' in achieving the global goal of 80 percent coverage in provision of antiretroviral prophylaxis for preventing mother-to-child transmission of HIV. The southern Nigerian state of Akwa Ibom has HIV prevalence rates well above the national average of 10.9 percent and HIV/AIDS awareness is low. To prevent mother-to-child transmission of HIV, steps that increase adherence to the World Health Organization's comprehensive approach to preventing mother-to-child transmission of HIV need to be taken.
At the same time, Nigeria has one of world's highest maternal mortality rates, accounting for 14 percent of the world's deaths related to childbearing. Many women deliver with unskilled birth attendants because of poverty, isolation, lack of access to health services, traditions, and/or superstition. It is essential to increase access to safe motherhood to keep both mothers and children alive.
To alleviate the various constraints (e.g., financial, spiritual, educational) that cause ultra-poor pregnant women in rural villages to deliver without skilled birth attendants, New Incentives will enable pregnant women to earn a monthly stipend conditional upon prenatal checkups, adequate nutrition, antiretroviral adherence, and delivery with skilled birth attendants. Each conditional cash transfer has two components: 1) direct cash to increase consumption of basic goods, and 2) a condition that stimulates long-term behavioral change. Through its Commitment to Action, New Incentives will not only decrease barriers to accessing health services, but it will also promote access to capital for ultra-poor pregnant women.
SEEKING: New Incentives is seeking partnerships to increase its brand penetration and initiate discussion around conditional cash transfers among the general public. It is also seeking funding partnerships to implement its novel conditional cash transfer program for ultra-poor pregnant women and newborns in southern Nigeria. New Incentives is looking to form individual, foundation, corporate, and institutional donor relationships in order to create a global network of support for conditional cash transfers that spans both non-profit and for-profit sectors, called the Global CCT Ambassador Network.
OFFERING: New Incentives would like to partner with organizations looking to increase utilization of social services. Specifically, New Incentives would like to partner with organizations working to increase the quality of education and health services, and organizations looking for ways to increase uptake of services on behalf of marginalized populations. New Incentives is interested in providing incentives to these populations to increase access to services, and in doing so, increase the viability of partner organizations. New Incentives is interested in providing funding to community-based organizations and service providers in developing countries that are interested in implementing conditional cash transfers or expanding conditional cash transfer programs.