Health

New Incentives

Research summary, last reviewed May 2026. US 501(c)(3), EIN 45-2368993; operates in Nigeria as the All Babies Are Equal Initiative. Official site.

Independent recognition: GiveWell Top Charity · The Life You Can Save recommended · Giving What We Can featured

Headline outcome: 6.8 million infants enrolled across more than 7,000 clinics

What does New Incentives do?

New Incentives runs a single programme, known in Nigeria as the All Babies Are Equal Initiative. When a caregiver in northern Nigeria brings their baby to a government clinic for a routine vaccination, New Incentives pays them a small cash incentive, around 1,000 naira per qualifying visit, roughly US$9.50 across the full schedule, with a completion bonus added in 2024.

The vaccines themselves are free, supplied by the Nigerian state with Gavi and UNICEF support. The problem the cash solves is everything around the vaccine: a caregiver in extreme rural poverty typically gives up a day’s subsistence work and pays for transport to reach the clinic. The incentive compensates that real cost, which is why the model is best understood as unblocking attendance rather than delivering vaccines. Mobile vaccination teams extend the programme to families who cannot reach a clinic at all.

The founding story is one of intellectual honesty. Founder Svetha Janumpalli started New Incentives in 2011 around an HIV-prevention cash transfer programme; by the end of 2013 the founders concluded the evidence for that design was weak, and rebuilt the organisation around childhood vaccination because that is what the clinic-level data told them would work. GiveWell incubated the new model from 2014.

Why did EveryDrop choose it?

New Incentives passed our four-stage vetting assessment: a clearly aligned charitable purpose (advancement of health and saving of lives), no evidence of undue private benefit, no public disbenefit, and access about as open as it is possible to be. Any caregiver attending an enrolled clinic qualifies; there is no fee and no eligibility filter, and the programme is deliberately targeted at the states where vaccination coverage is lowest.

It is also one of the most rigorously externally evaluated charities in the world. It has been a GiveWell Top Charity since November 2020, one of only four, with continuous published grant analysis, a September 2024 programme review and a formal retrospective lookback in July 2025.

How effective is it?

The programme was tested in a randomised controlled trial across 167 clinics in Katsina, Zamfara and Jigawa states between 2017 and 2020. It more than doubled the share of fully immunised infants, from around 25% in control areas to over 50% in programme areas. This sits on a wider evidence base: a landmark 2010 trial in India by Banerjee, Duflo and colleagues found even a tiny non-cash incentive raised full immunisation from 16% to 38%, and a 2022 Nature meta-analysis found no negative unintended consequences from vaccination incentives.

GiveWell’s September 2024 estimates: about US$18.21 per child enrolled, roughly US$4,500 per life saved (range US$1,500 to US$6,000), and 10 to 42 times the cost-effectiveness of unconditional cash transfers.

What are the open questions?

We publish what we are monitoring as well as what we like. The most material issue is the operating environment: northern Nigeria has serious insecurity, and GiveWell’s own grant analysis notes that some local government areas could not even be surveyed for security reasons, and that staff and caregivers face risk travelling to clinics. The programme adapts with mobile teams and area-level risk mapping, and we treat security as a standing monitoring item.

Three evidence questions remain live. Vaccine stockout days rose from about 7% during the trial to about 28% after scale-up, a strain on Nigeria’s supply chain that the charity works with state authorities to mitigate. New Incentives has found and publicly addressed fraudulent enrolment attempts and clinic documentation problems, with controls GiveWell judges did not significantly compromise the programme. And in 2024 GiveWell added a downward adjustment of 11 to 30% in new states for possible negative post-programme effects, an adjustment it describes as speculative and based on limited evidence; forthcoming coverage surveys should confirm or rebut it, and we will follow them.

Sources

This summary is derived from EveryDrop's internal vetting dossier, prepared under our four-stage assessment framework using public, verifiable sources. Assessments are re-checked every twelve months. If you spot something we should know, email [email protected].