We are pleased to invite research organizations and HIV programme implementing partners working in South Africa to submit proposals for rapid evaluations of interventions that are informed by behavioural economics, or nudges, that have the potential to improve services and outcomes within HIV programmes.
Selected proposals will receive the following support:
- Funding: Small grants to financially support the implementation and evaluation of BIT projects.
- Technical support: Indlela investigators and research associates will be able to offer guidance on intervention design, evaluation strategies, and partial support in project implementation.
More information on Indlela, the proposal submission process and what to include in the Application Form is included below.
Although HIV services have become widely available in South Africa, their success in reducing new infections is hindered by the “last mile” challenge of human behaviour. Due to behavioural factors affecting patients and providers, coverage of HIV services and health outcome targets are lower than desired. In particular, there is a need for higher awareness of HIV testing and engagement in care by the hardest-to-reach individuals such as men and young people.
Behavioural economics offers insights into human behaviour that can be useful for understanding the decisions made by patients and providers. These insights can also be valuable in identifying low-cost behaviour change interventions. In many countries around the world, behavioural economics insights have been used to develop “nudges”, or light touch, scalable interventions designed to influence human behaviour. These nudges have led to higher utilization of health services, enhanced performance of healthcare providers, and improvements in health outcomes.
Indlela is supported by the Bill & Melinda Gates Foundation and co-led by the University of Witwatersrand’s Health Economics and Epidemiology Research Office (HE2RO) and the University of Pennsylvania’s Center for Health Incentives and Behavioral Economics (CHIBE). To further the evidence-base on the use of behavioural interventions in HIV service delivery, Indlela plans to award small grants for Behavioural Insights Test (BIT) projects led by implementing organizations or research institutions in South Africa.
What is a Behavioural Insights Test (BIT)?
A BIT is a project that will rapidly test a low-cost, scalable intervention or service delivery innovation that is informed by behavioural economics and has the potential to overcome behavioural barriers to coverage of HIV services. BIT projects should seek to promote a specific patient and/or provider behaviour along the HIV care continuum and should include specific behavioural economics insights that motivate the intervention. An important feature of a BIT is an evaluation component to measure whether an intervention works.
What does an ideal BIT applicant look like?
Indlela seeks to collaborate with implementing organizations engaged in HIV service delivery in South Africa or research institutions in South Africa with close connections to HIV programmes. Collaborations of implementing partners, research organisations and health departments are also welcome.
Applicants should have these attributes:
- Interest in applying behavioural insights to address challenges encountered in HIV service delivery
- Willing to work collaboratively with the Indlela team
Committed to delivering the intervention and evaluating it as designed and agreed upon
- Open to dissemination of results with stakeholders and policymakers
- Preferably able to leverage existing resources to test the intervention
What are the key characteristics of an Indlela BIT intervention?
A BIT intervention or solution focuses on changing behaviours and outcomes related to HIV prevention, testing, linkage to care, retention or re-engagement in care. An ideal intervention has the following characteristics:
- Informed by behavioural economics principles
- Builds upon existing programmes and represents a lean, light-touch, and nimble modification or add-on
- Addresses challenges faced by either patients or providers (or both)
- Low-cost to implement and likely to be sustainable, with high potential to scale if successful
What are the key characteristics of an Indlela BIT evaluation?
The hallmark of a BIT evaluation is the rapid assessment of the intervention’s impact on behaviour. As such, each BIT project should include an evaluation component. Strong evaluation designs will include:
- An experimental or non-experimental approach to determining the intervention impact
- An ability to rapidly assess impact; an ideal overall project timeline would be <12 months
- Quantitative methods, plus qualitative or other approaches, where complementary
- Reliance on administrative or other existing or easily collected data (vs. new data collection)
What are some examples of behavioural solutions or ‘nudges’ that could be part of a BIT project?
Examples of nudges, interventions, and solutions that are informed by behavioural economics include:
- Counter present bias by making near-term benefits of using HIV services more salient in communications
- Leverage the principles of loss aversion and altruism in messages to patients
- Reference social norms and use social comparisons to influence the behaviour of patients or providers
- Use of checklists and default settings
- Utilize planning prompts and pledge forms that help to close the gap between intentions and actions
How are BIT projects funded and what can these funds be used for?
Awards will be executed by the University of Pennsylvania, through a sub-award from the Bill & Melinda Gates Foundation grant that supports Indlela. To receive a sub-award through Indlela, a BIT project must have a Principal Investigator (PI) or Project Lead who is based in a South African research institution or implementing organization. We envision BIT grants having the following attributes:
- Will vary in funding amount, depending on the scope of activities proposed
- Allowable costs may include those required for intervention delivery (material costs, personnel, etc.) and for evaluating the intervention (personnel, data collection, etc.)
- Costs are expected to be modest as nudges and other behavioural economics solutions are typically low-cost and easy to integrate into existing programmes
- Similarly, for evaluation costs, we encourage reliance on administrative or routine data when possible
- Indlela will contribute complementary researcher effort to provide technical and research support
What if an organization faces a challenge in HIV service delivery and is keen to develop a solution, but is not ready to submit a BIT proposal?
As a capacity building initiative, the Indlela team is eager to engage researchers and implementers in South Africa that are interested in gaining knowledge of behavioural economics and applying behavioural economics insights to challenges faced within HIV programmes. If you are not ready to submit a proposal but would like to discuss an idea with our team or possible implementation challenge that could be suited for a BIT project, we encourage you to contact us and schedule a consultation with our team: firstname.lastname@example.org.
BIT Proposal & Budget Considerations
Applicants should complete the brief four-part application form including Part I: Project overview & timeline, Part II: Proposal narrative, Part III: Team information and Part IV: Budget & justification.
Applicants should craft a clear problem statement that references a specific implementation challenge within the HIV care cascade and states the behavioural barriers that the project addresses. The proposal should also summarize the suggested intervention, as well as a brief description of its behavioural economics rationale. Successful BITs will include nudges and low-cost interventions that can ideally be implemented within existing HIV programmes along with a rapid evaluation that will enable us to learn whether it is effective.
We anticipate most projects will have budgets of approximately $25,000, though the potential budget range for projects is between $10,000 – $50,000. The budget should directly correlate with the project scope and scale. Some BIT project budgets may exceed this range, but this should include a clear justification in the proposal.
The Indlela team will provide complementary researcher and investigator effort to support BIT projects. This can include input on scientific aspects of the project from Indlela investigators with behavioural science expertise as well as support from other Indlela team members (Nudge Associates) in implementing projects. Support can include obtaining appropriate approvals and permissions including IRB if required, support for protocol and tool development if needed, and oversight support from Indlela Nudge Associates during the project. In your proposal, please specify what type of support you would like to receive from the Indlela team.
Request for Proposal (RFP) Cycles
This is the first Indlela BIT project funding cycle. We anticipate additional RFPs will be released in 2021-2022 and future proposals can be submitted if you are unable to apply in this cycle. Notifications of future funding cycles will be included in the Indlela newsletter and on the projects page.
Proposal Evaluation Process
Following the submission of a BIT proposal, the Indlela team will review all proposals and select the most promising BITs as finalists. The Indlela team will initiate conference calls with the finalists to assess the suitability of the BIT, offer further support to develop the BIT, or to propose changes that may be necessary. We aim to notify applicants of next steps within 1-2 months. Proposals will be evaluated on a rolling basis.
Proposal submissions open – February 24, 2021
Proposal submission deadline – April 09, 2021