Building capacity to design and test nudges and other behavioural solutions to improve the effectiveness of health services and achieve better health outcomes in South Africa.
Human behaviour poses a “last mile” challenge to ensuring the effectiveness of existing health services and maximizing the impact of available resources. Behavioural economics offers insights on human behaviour and decision-making that can be useful for identifying low-cost behavioural solutions (“nudges”) that increase uptake of health services and promote behaviour change more generally. In the past decade a number of governments and health systems globally have used behavioural science and rapid-testing of interventions to improve the efficiency of programs by forming “nudge units” to help develop low-cost interventions that have successfully resulted in behaviour change and improve health care delivery.
With support from the Bill and Melinda Gates Foundation, the University of Witwatersrand’s Health Economics and Epidemiology Research Office (HE2RO) and the University of Pennsylvania’s Center for Health Incentives and Behavioral Economics (CHIBE) are launching Indlela: Behavioural Insights for Better Health (Indlela means “the way” or “the path” in Zulu). Indlela is the first-of-its-kind unit focused specifically on improving the effectiveness of the public sector in delivering health care and achieving better health outcomes in South Africa. In the unit’s first 3 years it will focus specifically on building capacity to expand the use of behavioural economics within HIV prevention and treatment programs in South Africa and strengthen the ability of health service delivery providers and key research institutions to develop and test contextually appropriate interventions that are informed by behavioural science principles. In future years, the unit’s scope will expand beyond HIV to include other pressing public health issues in South Africa.
The main objectives of the Indlela unit will be to:
1. Increase knowledge and application of key behavioural economics insights among organizations delivering or supporting the delivery of health and HIV services;
2. Strengthen the technical capacity of local institutions to support government and implementing partners in developing and testing behavioural economics solutions.
Indlela will initially focus on developing and testing behavioural solutions that increase uptake of HIV testing, linkage to HIV care, re-engagement in HIV care. Over time, we see significant potential for the focus to expand to other health-related problems that are influenced by human behaviour. Indlela will begin by undertaking the following activities during the first 3 years beginning in 2020:
1. Workshops for researchers, HIV service delivery providers and those supporting implementation of the HIV programme. These will introduce principles of behavioural economics with concrete examples of how they can be used to develop simple, low-cost interventions. We seek to engage researchers, implementing organizations, and officials from provincial and national governments.
2. Supported pilot grants. This will support sustained engagement with workshop stakeholders and practical application of behavioural economics. We will oversee a pilot grant program in which researchers and implementers who participate in the workshops can test behavioural interventions in HIV testing and care
HE2RO staff involved
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