Behavior Economics and the Millennium Development Goals 4 and 5

1. Behavior Economics and the Millennium Development Goals 4 and 5 By DivyaThekkethala H571 Health Behavior

2. Goals for Discussion • Review Millennium Development Goals • Discuss Behavior Economics “Tricks” • Discuss how Behavior Economics relates to other theories • Discuss and Apply these tricks to MDGs

3. Millennium Development Goals

4. Specific Goals for 4 and 5 Goal 4: Reduce child mortality rates • Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate Under-five mortality rate • Infant (under 1) mortality rate • Proportion of 1-year-old children immunized against measles Goal 5: Improve maternal health • Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio Maternal mortality ratio • Proportion of births attended by skilled health personnel • Achieve, by 2015, universal access to reproductive health Contraceptive prevalence rate • Adolescent birth rate • Antenatal care coverage • Unmet need for family planning[

5. How can we apply Behavior Economics to take MDGs • Behavior economics: Intersection of psychology and economics Main Point: we rarely behave rationally Lack of Rational Behavior “Tricks”: • Framing Effects • Present Bias • Zero Price Effects • Band-wagoning /Social Norms • Loss Aversion

6. Trick #1: Framing Effects Gain: If you do X … “Increase your chance of surviving from 45% to 90%” Loss: If you don’t do X … “Decrease your chance of surviving from 90% to 45%” Which one is better?

7. Framing Effects Research shows … 1. Loss-framed are more persuasive than gain-framed 2.Gain-framed are more persuasive for preventative behaviors. Loss-framed are better for motivating screening, detection and immunization (one timers).

8. Present Bias • IMMEDIATE GRATIFICATION • People prefer immediate benefits to investment-future benefits • When it comes to applying cost benefit, people place more value on benefits today than benefits down the road • Solution: incentive schemes

9. Zero Price Effects • Everybody likes FREE.99 • Usage of preventative measures decreases dramatically when services aren’t free • This isn’t a question of “too expensive”, but a non-zero cost isn’t persuasive • Criteria to make something free • Wide spread uptake is required for maximum health benefit • Product is cost effective • Desired effort requires upfront investment for long term benefits

10. Zero Price Effects • Policy-maker’s Issues: fears that users will undervalue the product and refuse to pay for product in the future • Solution: Vouchers – coupon effect, you think you are getting a great deal

11. Band-wagoning and Social Norms • People are far more likely to do something if everyone else is … even if they aren’t particularly sure if they agree with it • Somewhat like, “peer pressure” or “trying to fit in”

12. “The Angelina Effect” • Jolie tested positive for BRCA1 gene • Probability that she would develop the disease 87%; after her surgery, her probability was just 5%

13. Loss Aversion • People view losses more heavily than gains • Avoiding the loss of $100 is more important than gaining $100 • We fear loss more than we love winning • Cost efficient: • Setting up a “birth savings account” = money is returned when baby is delivered by skilled attendant is better than simply paying women to get a skilled attendant

14. How can we apply these strategies to MDGs? • Framing Effects • Present Bias • Zero Price Effects • Band-wagoning /Social Norms • Loss Aversion

15. Where have we seen these before? • Framing Effects • Present Bias • Zero Price Effects • Band-wagoning /Social Norms • Loss Aversion • Value Expectancy Theories • Theory of Planned Beahvior • Social Cognitive theory • Fear Appeals • TTI

16. MDGs: Where are we now? • About 700 million fewer people lived in conditions of extreme poverty in 2010 than in 1990. • One in eight people still go to bed hungry, despite major progress. • Globally, nearly one in six children under age five are underweight; one in four are stunted. • An estimated 7 per cent of children under age five worldwide are now overweight, another aspect of malnutrition; one quarter of these children live in sub-Saharan Africa.

17. Concluding Points • While closing the gap on Child and Maternal MDGs for 2015 may require the input of more moneyfor cost effective, evidence based plans,its is necessary to use health behavior economics • What can researchers do? Collaborate with other theories • What can policy makers do? Apply theory to interventions and use novel approaches