New Incentives (YC S16 Nonprofit) helps Nigerian mothers deliver babies safely | Hacker News Reader

New Incentives (YC S16 Nonprofit) helps Nigerian mothers deliver babies safely

themacro.com

49 pointsstvnchn23 comments

I met Patrick (one of the co founders) in Lagos pre YC. He was really passionate about this project

This is a brilliant project I am excited about. I see it as a win-win. Some people are too poor to even take care of themselves. Rather than give them money (Basic Income?) how can we get them to perform particular activities while giving them free money?

I hope this succeeds because we need this to be applied to other sectors like education. i.e allow your kid to go to school and you will be rewarded.

Bravo New Incentives!

Hi HN, I'm a Co-founder at New Incentives. Happy to answer any questions. -Prat

What do you do to support the mother after birth? If she can't afford to have the baby, can she afford to care for it for the next 10+ years? Do you think your service is creating an "another mouth to feed" problem?

The main problem is not that they cannot afford to have the baby but that they are not delivering it safely at the health clinics. Instead, they are delivering it with traditional birth attendants. This is especially a problem because it can increase the chances of the baby being born diseases like HIV, which has a 50% chance of leading to death within the first two years. The cost of a baby being born with HIV runs into many thousands of dollars.

Also, infant mortality has a strong correlation with the fertility rate, so trying to increase the probability of survival of babies can help reduce the number of babies being born (which addresses the problem you mentioned).

Honest question, how does birthing the traditional way increase the chance of HIV infection? Also, are you doing anything to bring the positive aspects of the traditional into the clinic?

And your post is kind of grayed out, does that mean it's been downvoted? (I only see up vote option, do I need more points to downvote?)

Good question. Clinics are more hygienic (reducing the chance of blood transmission during birth), provide ARVs pre-birth (reduces HIV viral count), and give Nevirapine at birth (giving this to newborns immediately after birth is the biggest individual step that can reduce transmission).

Not sure why the post is grayed out or what it means. I believe only some members have downvoting privileges (I don't).

Thanks for clarifying!

"The cost of a baby being born with HIV runs into hundreds of thousands of dollars."

By what measure does it cost hundreds of thousands of dollars? Hardly anyone in Nigeria has hundreds of thousands of dollars.

This is the cost to the government and NGOs. Basically, this leads to a lifetime of consuming drugs which often need to be subsidized by the government and other orgs. Naturally, it also increases the probability of more people getting infected. The costs are hard to estimate but add up to a very large sum and consumes a lot of global aid money that could be better used if these babies weren't born with HIV.

Thanks for pointing that out. While the average estimated number is easily into the thousands of $$, there is not enough evidence to say that it is hundreds of thousands.

What to do you do, if mother leaves her baby at the clinic?

We haven't had this problem yet and no clinic has reported this as a potential issue either. From what we have seen, these mothers care about their babies A LOT!

In the article I see no mention of obstetric fistula [0]. This is a serious problem that leads to shame, pain, and serious economic loss for mothers who suffer it. Am I correct to assume your program seeks to prevent fistulas from occurring? Does your program also include include care for women with fistulas?

[0] https://en.wikipedia.org/wiki/Obstetric_fistula

Obstetric fistula is not one of our focus areas.

Congrats NI!

How did you come across this problem/solution?

Thanks Jayme!

Svetha (CEO & co-founder) came across conditional cash transfers (CCTs) while doing research in effective ways of giving AID in developing countries. CCTs have seen incredible success in Mexico, Brazil, and several other countries.

The current idea was a pivot after trying to fund CCTs through partners in various countries. The focus was to save lives through CCTs. Infant mortality is a big problem and Nigeria accounts for one out of three children born with HIV. That's how the org started doing CCTs for reducing HIV transmission and has now expanded beyond HIV transmission.

Why not, instead of paying mothers to birth at clinics, give the Nevirapine to the traditional birth attendants. Then you won't have to twist arms to get people to change their traditions and you can still prevent the spread of HIV?

Great question. Top three reasons: 1) There are many benefits from delivering newborns in health clinics outside of Nevirapine. 2) It would be much more challenging to reach all of the traditional birth attendants, maintain constant supply of Nevirapine, and monitor proper administration. Moreover, in our case, the cost of the program is the cash transfers and this is a large benefit for program participants. 3) Traditional birth attendants do not consistently test women for HIV when they deliver, because of various reasons (one being it is bad for business to share negative news).

What field presence do you have to carry out this work?

We founded our own organization in Nigeria to be able to do this, all the employees are hired directly by our organization. Women are enrolled at the clinics by our team and then called to give the cash transfer code (codes are redeemable at ATMs).

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