Prize-linked Savings Initiatives for Promoting Better Health and Economic Outcomes in Kenya

Not Applicable

Completed

• Conditions: HIV/AIDS
• Interventions: Other: Prize-linked savings

• Registration Number: NCT04013295
• Lead Sponsor: University of Pennsylvania

Brief Summary

Transactional sex is widely believed to be among the driving factors for the high HIV rates among adolescent girls and young women in Kenya. We will pilot a randomized trial among men in Kenya to assess whether prize-linked savings opportunities reduce spending on transactional sex. The project will randomize men to the savings intervention and assess changes in key economic and self-reported health outcomes over a 3-6 month period.

Detailed Description

Despite a large decline in new adult HIV infections in eastern and southern Africa from 2005-2015, progress has slowed in recent years. In particular, HIV risk among adolescent girls and young women remains high. Transactional sex, or the exchange of material support in non-commercial sexual relationships, is widely believed to be among the main driving factors for the HIV risk in this population. There is a large gap when it comes to interventions targeting men who engage in transactional sex. The proposed pilot project seeks to fill this important gap by using behavioral economic principles to promote behavior change among men.

The project will assess a novel prize-linked savings intervention designed to shift men's income away from alcohol and transactional sex and towards saving for the future. Prize-linked savings accounts offer savers a random, lottery-like payout proportional to the amount participants save, instead of traditional interest income. A number of banks, employers, and policymakers have promoted this low-cost, scalable approach to increasing savings among low-income individuals. However, there have been no assessments of whether prize-linked savings interventions can induce changes in key health-related behaviors as well. We will conduct a pilot randomized trial among men in Kenya to assess whether offering prize-linked savings opportunities leads to reduced spending on alcohol and transactional sex. The project will enroll men who in communities with high HIV risk, randomize them to the savings intervention, and assess changes in key economic and self-reported health outcomes over a 3-month period with baseline and follow-up surveys. We hypothesize that men randomized to the prize-linked savings intervention will have higher savings, lower expenditure on transactional sex, alcohol, and gambling, and lower rates of participation in risk behaviors such as transactional sex, relative to men randomized to the standard bank account control group.

Study Timeline

• Study Start: 2018-09-03
• Primary Completion: 2018-12-18
• Study Completion: 2018-12-18
• Study First Submitted: 2019-07-03
• Study First Submitted QC: 2019-07-08
• Study First Posted: 2019-07-09
• Status Verified: 2023-04
• Last Update Submitted: 2023-04-20
• Last Update Posted: 2023-04-21

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Male
• Target Recruitment: 300

Inclusion Criteria

• Resident in selected shoreline communities and their hinterlands in Siaya County, Kenya
• Male
• Age 21 years and above
• Primary or secondary occupation is fishing or transportation (i.e. motorbike taxi driver)
• Owns mobile phone
• Is willing to open savings account with a local bank and has, or is willing to obtain, the necessary documents (national identification card, Kenya Revenue authority PIN) to do so

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Exclusion Criteria

• Planning to relocate from study communities in the next 6 months
• Does not express willingness to open a savings account

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Prize-linked savings intervention	Prize-linked savings	Participants in the intervention group will be assisted with opening bank accounts at the partner bank and will be eligible for monetary rewards linked to the amount they save in these project accounts. During the intervention period, information about participants' savings activities will be shared with the study team at regular intervals by the bank. Winners will learn of their prize via text message and will have their prize money deposited into their accounts. Respondents who did not win the lottery will also receive a text message, which will remind them to save.

Primary Outcome Measures

Name	Time	Method
Savings balance	Measured throughout follow-up period (approx 3 months)	Total increase in savings balance over the study period (continuous measure)
Expenditures on alcohol	Recall period: past 7 days, measured in endline survey (approx 3 months after enrollment)	Total spending on alcohol in past 7 days
Increase in savings balance	Measured throughout follow-up period (approx 3 months)	This is a binary variable equal to 1 if the respondent's savings balance increased over the study period, and zero otherwise.
Participation in and expenditures on transactional sex	Recall period: past month, measured in endline survey (approx 3 months after enrollment)	Total spending on transactional sex in past month, and binary indicator for any spending

Secondary Outcome Measures

Name	Time	Method
Savings	approx 3 month follow up period	Net increase in both the savings balance and in self-reported total savings from all sources, in each lottery period and over the entire study period
Expenditures on non-food items	Recall period: past 7 days, measured in endline survey	Money spent in past 7 days on all non-food items
Expenditures on food	Recall period: past 7 days, measured in endline survey	Money spent in past 7 days on food

Trial Locations

Locations (1)

University of Pennsylvania; 🇺🇸 Philadelphia, Pennsylvania, United States