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Building capacity to design and test nudges and other behavioural solutions to improve the effectiveness of health services and achieve better health outcomes in South Africa.

The Indlela team is pleased to share these highlights from the first quarter of 2021:

  • We completed our first Behavioural Insights Test (BIT) Development Virtual Workshop series. See below to learn more.

  • Are you a researcher or implementing organisation working in South Africa who is interested in collaborating with Indlela to develop and test a behavioural solution in the context of HIV service delivery? Please reach out to us and consider applying for a grant to carry out a Behavioural Insights Test (BIT). See our Request for Proposals

  • We have officially launched the new Indlela website! Take a look and learn more about us.  

In this edition of our newsletter, we share several team and project updates and provide links to interesting resources related to HIV and behavioural economics. For more frequent updates, follow us on Twitter or visit the Indlela website.

  Project Updates

Behavioural Insights Test (BIT) Development Virtual Workshop Series

We recently completed the 3-part BIT Development Virtual Workshop Series, which included over 30 participants from 20 research and implementing organizations in South Africa. The goal of the workshop series was to build participants’ knowledge and skills in behavioural economics while also providing help to develop pilot projects that will rapidly test behavioural solutions in HIV programmes. The workshop presentations & video recordings are available at this link and we’ve summarized the workshop topics below.

Workshop 1: Identifying behavioural barriers to improving HIV outcomes

Harsha Thirumurthy launched the first workshop by presenting on the behavioural economics principle of scarcity. Prior to the workshop, we asked participants to submit problem statements outlining challenges they experience in their work in HIV service delivery, and during the workshop divided participants into breakout rooms to discuss these in more depth. Next, we had an expert panel which included several external behavioural scientists who shared some insights on how to refine the problem statements shared.

Workshop 2: Designing potential solutions
Alison Buttenheim presented on Choice Architecture and the discussion was on designing potential solutions. Next, the Indlela team selected problem statements from Workshop 1 and conducted a ‘design sprint’ to brainstorm potential behavioural solutions. Participants also had an opportunity to join the Indlela team for individualized consultations to share ideas and solicit advice.
Workshop 3: Developing methods to test solutions
This workshop focused on developing methods to test behavioural solutions. Brendan Maughan-Brown presented on Social Norms and this was followed by presentations of the first two Indlela BIT projects by the Aurum Institute and Right to Care. The focus of the workshop was on the appropriate methodologies for rapidly evaluating a BIT. We concluded the workshop with a preview of the BIT project Request for Proposals (RFP) and a social happy half hour to congratulate participants on completing the workshop.

Indlela Affiliates

We would like to thank our six Indlela affiliates who joined us for the BIT Development Virtual Workshop series and provided expert guidance and insights on BE principles relevant to developing BIT projects.
Request for Proposals - Behavioural Insights Tests (BITs)

We are inviting organizations working in South Africa to submit proposals for Behavioural Insights Test (BIT) projects for the rapid implementation and evaluation of nudges and other behavioural economics solutions that have the potential to improve service delivery and health outcomes in HIV programmes. Selected proposals will receive funding and technical support. 

Interested in working with and collaborating with Indlela? Please visit these links to the RFP and application form. Please also feel free to circulate this notice within your networks. Deadline for the first cycle of submissions: March 31, 2021

Launch of the Indlela website

We are very excited to have launched the Indlela website and encourage you to browse this site via this link On the website, you will be able to find updates on current projects, opportunities to partner with Indlela, information about the team, access to other Indlela products and links to resources. We will use the website as a platform to continue to cultivate the Indlela community of practice and showcase progress on the various BIT projects.

Join our Whatsapp Group

We have set up a whatsapp group to post announcements and share helpful resources on behavioural economics. You are welcome to join our community of practice by scanning the QR code image or send us your contact details via email and we will add you to the group.
Indlela Team 

Getting to know the Indlela team

Alison Buttenheim, Indlela Behavioural Design Lead. I have been on the faculty at the University of Pennsylvania since 2011. I am an Associate Professor of Nursing and Health Policy, and Scientific Director of Penn’s Center for Health Incentives and Behavioral Economics. 
My research interests include the behavioural aspects of infectious disease prevention, including HIV and vector-borne diseases like Chagas. Since March 2020, I have also done a lot of work on COVID-19 prevention and mitigation, including COVID-19 vaccine acceptance and optimal delivery. 

Career Nudge: I went to business school but didn’t really find a career path after my MBA that clicked. I wanted to work in global population health and was lucky to meet the woman who became my mentor and advisor. She convinced me to start a PhD program.
Vision for Indlela: I get very excited about the potential for behavioural insights to boost the effectiveness and reach of existing health care services and programs. I hope that Indlela can be a platform for sharing that excitement and potential with the HIV community in South Africa.

Biggest Achievements: I’m very proud of raising my two daughters with my partner. They are 18 and 21 years old and starting to find their path -- their Indlela! -- into adulthood. 

Brendan Maughan-Brown, Indlela Research Faculty. I have been a Chief Research Officer at the Southern Africa Labour and Development Research Unit (SALDRU), University of Cape Town since 2011.
My research interests focus on behavioural interventions to increase the use of health services and products. I’m developing a video-based intervention that leverages affect and availability heuristics to encourage treatment uptake among newly diagnosed HIV-positive men. I’m also conducting research to improve hand washing and health among young children (Project Hope Soap), which targets habit formation.

Career Nudge: I was nudged (pushed, even) toward a career in public health after a visit to a hospital ward in Zambia (2000), which was overcrowded with patients with AIDS-related illnesses. I was drawn to BE through witnessing many choices people made regarding HIV treatment. Having negotiated treatment for depression myself, I am vested in research that supports treatment uptake and adherence.

Vision for Indlela: Gains in health and well-being will be substantial when the default is for programs to recognize  behavioural challenges and designed from the conceptual phase to counter these barriers using behavioural science principles. My vision is for Indlela to be a key information source for South African policy makers and service providers to learn about BE and its application to strengthen the country’s programmes.

Biggest Achievements:
Professionally, being part of an incredible network of colleagues from around the world, from whom I’m constantly learning. Personally, building a wonderful partnership with my spouse, working together to raise two happy and thriving daughters.

Achievements of the Indlela team

Candice Chetty-Makkan is a guest associate editor for the research topic "The consequences of the COVID-19 pandemic on reproductive health research, ethical considerations, program implementation and public health service delivery”. Submissions to The Frontiers in Reproductive Health HIV and STIs journal are currently open.
What have we published?

Harsha Thirumurthy, Noora Marcus, and colleagues from the University of Pennysylvania and Drexel University published an article Financial incentives and real-time adherence monitoring to promote daily adherence to HIV treatment and viral suppression among people living with HIV in the Journal of Acquired Immune Deficiency Syndrome (JAIDS). This was a pilot study conducted in Philadelphia, Pennsylvania to assess the feasibility of using wireless devices and financial incentives to motivate medication adherence among HIV-positive adults in the U.S. Findings suggest that daily financial incentives coupled with real-time adherence monitoring is a promising strategy to support ART adherence among HIV-positive individuals who are not virally suppressed.

Candice Chetty-Makkan and colleagues published an article on Exploring perceptions of low risk behaviour and drivers to test for HIV among South African youth in PLOS One. Despite perceptions of low risk to HIV, youth remain vulnerable to HIV. Youth highlighted that support from parents, receiving incentives, improved confidentiality during HIV testing and receiving information about HIV via social media platforms were potential drivers that could motivate them to test for HIV.
What are we reading?

Michael Hallsworth and Elsperth Kirkman authored this handbook entitled Behavioral Insights, which presents the history, current practice and future directions of behavioural insights. 

The impact of the COVID-19 lockdown on HIV care in 65 South African primary care clinics: an interrupted time series analysis estimated the impact of the COVID-19 lockdown on HIV testing, ART initiation, and retention in HIV care before and after the national lockdown. The findings showed that during lockdown HIV services were generally maintained for people already receiving ART, but HIV testing and subsequent treatment initiation were impeded. This manuscript highlights the importance of increasing HIV testing and ART initiation during any future COVID-19 lockdown restrictions.
What are we listening to?
In this Behavioural Science podcast series, entitled Core Insights, host Trevor Barnes interviews Ivo Vlaev, Professor of Behavioural Science, on How behavioural science nudges can improve our health.

In this HIV podcast series on “HIV Matters” from the  University of North Carolina School of Medicine, Dr. Adaora Adimora describes the challenges faced by women and minorities in accessing HIV care. 


What are we watching?
This inspiring video on HIV and COVID from the World Health Organisation’s Global HIV Programme, highlights the real-life experience of Dorothy Mokgomotsi who offered her home to Project PrEP’s mobile clinic teams during South Africa’s  first COVID-19 lockdown.

This is an interesting webinar on Behavioral Economics in Healthcare, hosted by Pfizer and The Economist Intelligence Unit.

We are hiring Behavioural Science Researchers (Nudge Associates). Click here to access the job description and we look forward to receiving your application.



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