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DOES MONEY MEAN ANYTHING to a busy pregnant mother in a remote rural village, w/o clean water, sanitation, electricity? WHAT DOES?

Please help me find a way to WALK IN HER SHOES.

Does a token amount of MONEY show *respect* and *empowerment* to rural pregnant women in Tamil Nadu, India? Or, is there a BETTER INCENTIVE?

How do we INCENTIVIZE self care and participation in health care initiatives in remote rural low-income communities? (I am guessing it is not with money.)

I am working with a healthcare team that is launching a new digital technology for distribution of healthcare education and monitoring of routine care throughout pregnancy in rural India,Tamil Nadu. We are tasked with providing *incentives* for participation, active monitoring, and regular attendance. The current plan is to provide a token sum of money. I believe that there is a strong possibility that this could simply be an insult.

A blog post by a US physician notes:

"4. Providing incentives. Incentives for patients to be better participants in their own healthcare need not be overt. It might be in the form of a physician’s conveying sensitivity to costs by prescribing the most economical medications, minimizing tests as well as acknowledging the issue as a concern. Another is to involving decisions and plans with a caregiver who can help achieve established goals along with the patient. In addition, the previous three points [which were (1) establish a relationship, (2) improve the patient and caregiver knowledge base, and (3) utilize digital health technology tools...patient portals, apps, reliable websites) will also incentivize the patient via *respect* and *empowerment*." [Emphasis added; Summary of 'three points' added.]

Again, does a token amount of MONEY show *respect* and *empowerment* within this culture? Or, is there a BETTER INCENTIVE?



  • Mar 4 2014: Thank you, Fritzie, for the Poverty Action Lab referral. Specialized information on the specific communities would be ideal.

    I am hopeful that, perhaps, some TED followers will have regional experience in Tamil Nadu. That would be fabulous. Pregnancy and birth are such sensitive healthcare topics. As this new effort is in the design phase, this would be the ideal time to introduce new incentive methods into the basic structure. Ideally, an alternative incentive method could potentially encourage networking between women and mothers in the same community to help sustain the knowledge base and encourage patient empowerment.

    Thanks, again. I am grateful for the opportunity to submit a question to the TED community.
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    Mar 4 2014: Theresa, look up the Poverty Action Lab at MIT and the paperback book Poor Economics by Banarjee and Duflo. Duflo is a TED speaker. They answer questions like yours by running experiments in the sort of location where you are working. Banarjee specializes in services to indigent communities in India.

    Good luck to you. It is very smart to do your cultural homework on this.