Varsha Venugopal

And in the subsequent versions, they have been looking at cost effectiveness.

And especially because they were looking to advise the Haryana state government on how to go about this.

they were very keen to look at not just impact, but cost effectiveness.

So if you just looked at impact, the combination of conditional cash transfers plus SMS plus ambassadors is the most impactful.

It has the highest effect sizes.

But when you look at it from the cost effectiveness perspective, it is the combination of only SMS and ambassadors.

And one can see the rationale for that.

setting up and running conditional cash transfers can be a fairly expensive operation.

Yes, yes.

So for us, the plan is very much to start with this SMS reminders plus ambassadors.

But maybe at a later date, there may be certain pockets which lend themselves better to conditional cash transfers.

It's not something we're completely ruling out, but it's not something in our portfolio of programs at the moment.

Yeah, no, that's a great question.

So our colleagues at Charity Science Health did undertake this meta-evaluation in 2019 with the nine existing randomized trials, and they found a 7.4 percentage point increase in full immunization due to SMS reminders.

So then to be conservative, they also ran the meta-analysis after subjectively making various substantial discounts on the reported effect sizes.

And this reduced estimated effect size is around 3.2 percentage points.

So our sense is the range of effect size is somewhere between 3.2 and 7.4.

But in all these cases, the program is still cost-effective.

I think one point we are aware of is we were quite clear on focusing on SMS versus, say, WhatsApp, because based on our research, we could see that the smartphone penetration was still not as high as regular phones.

So we are quite keen on focusing on text messages, but we are also quite aware of the high correlation between text.