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Our Daily Bleg: Some Good Public-Health Incentives, Please

Please take a look at the following bleg and offer whatever fruitful ideas you might have.

Dear Freakonomics,
My name is Michael Frank and I recently began working for a start-up NGO in Mali that strives to improve health. One of our programs is called “Action for Health,” which provides in-need families with access to free health care in exchange for doing a set number of predefined actions that benefit public health.
The logic behind this program is that studies have shown there to be an enormous jump in the percentage of citizens who choose to receive health care in Mali when it is free as opposed to just heavily subsidized. We require the actions be done so that the residents don’t take the free care for granted and because these actions improve public health either for the individual or the community.
A good action for health is something that improves health, is easily measurable, and is not so burdensome that it seriously hinders the participation of this in-need population. The action of a comprehensive hand-washing program for example, as detailed in Atul Gawande‘s new book The Checklist Manifesto, fits two of these criteria but it is not ultimately easy to monitor compliance. One recent action for health that fit our three criteria reasonably well was a recycling day, during which residents had to spend the day picking up the trash that is ubiquitous on the streets in Malian slum neighborhoods.
My bleg is: What other ideas do people have for “good actions for health” that fit our criteria? I’d also be interested for any other ideas that people had for our NGO in general. Thanks.


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