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A randomized controlled trial to test financial incentives for COVID-19 vaccination in Ghana

Nature Medicine volume 28, pages 1516–1517 (2022)Cite this article

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To the Editor — Achieving high levels of vaccine uptake across Africa will be critical to achieving global COVID-19 vaccination. Cash incentives have been proposed as a way to improve the efficiency and equity of the roll-out in Africa1. While there is a large body of experimental evidence suggesting that financial incentives can promote healthcare use2, studies on the promotion of COVID-19 vaccination uptake from high-income countries have had mixed results. Large randomized controlled trials (RCTs) of financial incentives in Sweden and the USA have produced conflicting results about their effect on the uptake of COVID-19 vaccines3,4.

The Ghana Financial Incentives study is an RCT designed primarily to determine whether cash incentives, which participants are informed about via a video message, increase uptake of COVID-19 vaccines. In addition, we also explore: the relative effect of cash incentives versus providing health information; how different levels of cash incentives may influence vaccine uptake; and the potential for spillover effects of incentives, whereby providing financial incentives in the treatment arm may affect vaccine uptake among others who have not been treated.

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Fig. 1: Flow chart of the Ghana Financial Incentives experiment.

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Acknowledgements

This research was supported by funding from the NIHR Oxford Biomedical Research Centre, Hitotsubashi Institute for Advanced Study and the University of Santiago, Chile. M.V. is partly supported by the NIHR Applied Research Collaboration Oxford and Thames Valley. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

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Authors and Affiliations

  1. Nuffield College, University of Oxford, Oxford, UK

    Raymond Duch

  2. University of Ghana, Accra, Ghana

    Edward Asiedu

  3. Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan

    Ryota Nakamura & Thomas Rouyard

  4. Centre for Experimental Social Sciences, University of Santiago of Chile (USACH), Santiago, Chile

    Carlos Yevenes

  5. Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK

    Laurence Roope, Mara Violato & Philip Clarke

  6. University of Melbourne, Melbourne, Victoria, Australia

    Philip Clarke

Authors
  1. Raymond Duch
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  2. Edward Asiedu
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  3. Ryota Nakamura
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  4. Thomas Rouyard
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  5. Carlos Yevenes
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  6. Laurence Roope
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  7. Mara Violato
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  8. Philip Clarke
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Contributions

All authors were involved in the conceptualization of this correspondence. R.D., E.A. and P.C. were involved in overall study design. P.C. and R.D. prepared the first draft. All authors were involved in reviewing and editing.

Corresponding author

Correspondence to Philip Clarke.

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The authors declare no competing interests.

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Duch, R., Asiedu, E., Nakamura, R. et al. A randomized controlled trial to test financial incentives for COVID-19 vaccination in Ghana. Nat Med 28, 1516–1517 (2022). https://doi.org/10.1038/s41591-022-01876-2

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