Publication: Evaluation of a financial incentive intervention on malaria prevalence among the residents in Lake Victoria basin, Kenya: study protocol for a cluster-randomized controlled trial
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2024-03-04
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Abstract
Background In the Lake Victoria basin of western Kenya, malaria remains highly endemic despite high cover-
age of interventions such as mass distribution of long-lasting insecticidal nets (LLIN), indoor residual spraying (IRS)
programs, and improvement of availability and accessibility of rapid diagnostic tests (RDT) and artemisinin-based
combination therapy (ACT) at community healthcare facilities. We hypothesize that one major cause of the residual
transmission is the lack of motivation among residents for malaria prevention and early treatment.
Methods This study will aim to develop a demand-side policy tool to encourage local residents’ active malaria
prevention and early treatment-seeking behaviors. We examine the causal impact of a financial incentive interven-
tion complemented with malaria education to residents in malaria-prone areas. A cluster-randomized controlled
trial is designed to assess the effect of the financial incentive intervention on reducing malaria prevalence in resi-
dents of Suba South in Homa Bay County, Kenya. The intervention includes two components. The first component
is the introduction of a financial incentive scheme tied to negative RDT results for malaria infection among the target
population. This study is an attempt to promote behavioral changes in the residents by providing them with mon-
etary incentives. The project has two different forms of incentive schemes. One is a conditional cash transfer (CCT)
that offers a small reward (200 Ksh) for non-infected subjects during the follow-up survey, and the other is a lottery
incentive scheme (LIS) that gives a lottery with a 10% chance of winning a large reward (2000 Ksh) instead of the small
reward. The second component is a knowledge enhancement with animated tablet-based malaria educational
material (EDU) developed by the research team. It complements the incentive scheme by providing the appropriate
knowledge to the residents for malaria elimination. We evaluate the intervention’s impact on the residents’ malaria
prevalence using a cluster-randomized control trial.
Discussion A policy tool to encourage active malaria prevention and early treatment to residents in Suba South,
examined in this trial, may benefit other malaria-endemic counties and be incorporated as part of Kenya’s national
malaria elimination strategy.