I'm Svetha Janumpalli, founder and CEO of New Incentives. We run a conditional cash transfer program in northern Nigeria that provides small incentives to caregivers to complete routine infant vaccination schedules.
Today, we operate across more than 7,000 clinics and have enrolled 6.8 million infants.
GiveWell’s most recent analysis suggests our program is substantially more cost-effective than earlier estimates.
Our program currently costs roughly $16 per infant enrolled. During our RCT period, we averaged ~27,000 monthly cash transfers. In 2025, we averaged over 760,000 per month, a ~28× increase.
While we’re confident in the core results, there are still important open questions, particularly around long-term effects, scalability to new contexts, and how the model performs outside our current operating areas. We are interested in testing whether variations of the model can work in lower-density or differently constrained settings.
I’d love to answer your questions about what we’ve learned along the way, and I’m happy to engage on detailed or critical questions. We’ve learned a lot from mistakes and ongoing uncertainty. A few areas I'm especially happy to dig into:
- Operations and scale. What it takes to go from a small pilot to thousands of clinics in northern Nigeria: the logistics, what broke along the way, and what surprised us.
- Evidence and measurement. How we think about the RCT vs ongoing monitoring, what we know, and what remains uncertain.
- What’s ahead. How we think about expansion, trade-offs across delivery models, and areas we’re currently exploring.
We’re particularly interested in questions that challenge our assumptions.
I’ll be collecting questions over the next two weeks and will post responses on May 20th.
Hi Svetha,
Thanks for accepting these questions and for the impressive work that New Incentives has achieved! I'd like to ask if you have any new data about the effect of the NI-ABAE program on overall health-care attendance behaviour of families - has the program generated any additional data about whether CCTs lead to families prioritizing the incentivized infant vaccine visits over other healthcare visits (including those for other family members) for which no incentive is paid? Or conversely, perhaps other healthcare visits might also increase for some reason? Thanks!
Hello, Svetha.
At a recent global health simulation conference, I pushed the concept of New Incentives to facilitate vaccinations. However, misconceptions around the effects of cash transfers continue to exist, despite strong evidence to the contrary. GiveWell also mentions in their evaluation that "There is some opposition to New Incentives’ program within the Nigerian federal government, which poses a potential threat to the sustainability of the program long-term." How do you address misconceptions, and how are you working to persuade the government to provide more support to the program?
Hey Svetha - I have a lot of admiration for what you and your team have built at New Incentives. A couple of questions:
1. Could you describe how New Incentives has used evidence throughout its history to inform strategic pivots / changes to its intervention, and what you have learned from this process?
2. The KPIs and cost-effectiveness figures that New Incentives has achieves are remarkable. What has it taken (that may not be visible in these numbers) to build an organisation and foster a team to achieve these results? What are some generalisable learnings / frameworks that may assist other organisations in their growth / scaling journeys?
3. I understand that New Incentives is listed as one of GiveWell's Top Charities which I assume helps with bringing in significant philanthropic support. From my experience at the recent Skoll Conference, there is a lot of discussion right now of engaging with government as the doers and payers at scale - particularly as philanthropy has gone through a recent sea-change. Are you thinking about sustainability and engagement with government as a route to further scale, or is the current model of philanthropic support the major vector that you see for ongoing scaling of your intervention?
Hey Svetha! Thanks for doing this AMA.
Two questions:
Not picking your program out in particular, this is a problem everyone trying to do good faces, including our team on the EA Forum.