The impact of financial incentives on preventing HIV in newborns

One in three children worldwide born with HIV is in Nigeria. Transmission of HIV from mothers to children is preventable, but it requires completion of many treatment steps. Women are lost at various points along the treatment plan, and in Nigeria only 30% of pregnant women with HIV receive these services.

New research explores the impact of providing financial incentives for pregnant women in Akwa Ibom, Nigeria, to complete steps to prevent transmitting HIV to their children. Women participating in the incentives program received money and phone credits when they registered for prenatal care, a 2nd transfer when they delivered the baby at the same facility, and a 3rd when they returned to get an early infant diagnosis test for HIV. The women also received phone calls and text messages to verify that they received the money and encourage them to deliver at a health facility.

Women who received the cash were more likely to deliver babies at a facility; to have their newborn receive HIV medication at birth; and to obtain an infant diagnosis test. Most women reported using the money to buy items for their newborns like food, clothing and toiletries.

This is one of only two studies so far to look specifically at cash incentives for preventing transmission of HIV from mothers to children. It contributes to the growing evidence on the effectiveness of conditional cash transfers to encourage healthy behaviors.

White the study suggests that these incentives can increase retention in this part of Nigeria, a large number of women still did not opt to deliver at a facility or have their child tested for HIV. Financial incentives may be a promising strategy for reducing HIV infections in newborns, but it is not a panacea and additional strategies are needed to improve adherence to care.