Global Health, Poverty and Development

The Main Point of the Articl

The article under consideration is headlined “Behavioral Economics: The Key to Closing the Gap on Maternal, Newborn and Child Survival for Millennium Development Goals 4 and 5?” It has been written by Alison Buttenheim and David Asch. The authors have covered the issues related to closing the gap concerning the maternal and newborn deaths as a part of the Millennium Development goals. The authors assert that the goal of decreasing the numbers associated with the deaths was expected to be accomplished till 2015. Despite many interventions, mostly financial, the outcome was barely reached but still many problems remained unsolved. Considering this, the authors assert that the pure financial approach towards the problem of maternal and newborn deaths is not comprehensive enough. The decrease of the prices for the services that might reduce the risks is effective, yet only to certain extent. Still, the occurrence of deaths is quite frequent. Therefore, the authors assert that the implementers of the strategies aimed at the accomplishment of the Millennium Development Goals, but they should pay more attention to the behavioral economics as the underlying foundation for the decision-making and health-related change. They suggest five principles that need to be followed in order to boost the efforts that will improve the maternal, child, and newborn deaths statistics.


The authors provide that the burden associated with the maternal, newborn, and child deaths is tremendous. Still, many of the deaths could be prevented in case timely and effective interventions are performed. The strategy of combatting with this challenge focused mainly on the low-cost interventions including the immunization of the citizens and the emergency obstetric care that might reduce the mortality and improve health state of the patients. Many people debate that there should be an increased funding to fight all the challenges. At the same time, the authors assert that there is a growing number of the experts that suggest the behavioral economics as the key for resolving these issues. Considering this, the authors discuss five behavioral principles that might be well employed to combat child mortality. The list, of course, is not exhaustive; yet, it might be considered as the basis to start from.

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The first principle refers to the framing effects. The authors claim that the formulation of the offer of immunization might significantly affect the decision-making process of the patient. They claim that the loss-framed messages that assert on the loss more than on the benefits gained and emphasize on the harms that might occur in case of inability to take action, are more persuasive than the ones supposing certain gain from the action. The authors also assert that in this case the behavioral principles are linked to the principles that are used in the social marketing.

Another principle is called the present bias. Usually, the people are lured by easily accomplished or reached pleasures. Therefore, one usually choses ice cream over attending the gym. Therefore, people are believed to place more weight on the costs realized today than in the future. The present-day bias create obstacles for investing into the future. Therefore, while designing the methods for changing one’s behavior, the creators should consider the costs (time, efforts, etc.) that the target audience will have to pay to get the benefit. If the benefit is far-reaching, future-based, or even unlikely to happen, the chances that the person will follow the intentions of the designers decrease automatically.

The third principle is called zero price and basically refers to the situation when certain service or price is offered for free. The authors assert that the paradox of such aero price is that the demand for such product tends to decrease significantly. Therefore, awaiting for the thousands of patients or clients who will be willing to get the product or services for free, designers of the project, in fact, get none of them and zero result of their project. The behavioral change does not occur, and the resources are wasted. The authors also claim that not only the clear zero price provokes this effect but also the vouchers or coupons that are granted for free to the young mothers.

The two final principles include the bandwagoning effect and the loss aversion. The first one claims that the people usually tend to follow the behaviors and preferences of those with whom they are living and by whom they are surrounded. In other words, they are frequently guided by the social norms without considering the role, effects, and adequacy of such rules. Therefore, the authors suggest to involve a small group of women and persuade them of the effects of the new product or service. Then this “tribe” might be sent to the different corners of the city where they will definitely start promoting it to others in case they like it and benefit from it. Finally, the loss aversion principle asserts that the people focus more on the insignificant loss rather than the huge benefit.

Highlighting the importance of the above-mentioned principles, the authors also stressed that they should be followed by all key stakeholders and enumerated all of them. First of all, the list includes the conveners of MNCH initiatives that should consider both the possibility of change and costs associated. The researches should also focus on the further developments of these principles and their implementation in practice. The health ministries of the governments are to be more open to the initiatives of the researchers and investigators and launch at least the pilot project that will help to test the theories and discover the most effective practices. More than that, they are also responsible for the coordination and ensuring of the uniform approach to the healthcare issues. The NGOs and staff that is employed at the health programs are expected to go through the series of trainings that would inform them and teach the behavioral principles helping to redirect the people into the needed stream as well as ensure the higher results and efficiency of the programs run by them.


The discussed article is indeed extremely effective both in the manner of the material presented and the initiatives suggested. It outlines the problem and clearly provides the methods for dealing with it. The principles discussed here are indeed based on the marketing foundations that are quite often employed by the market-oriented professionals. As the article shows, the experts today might well employ the knowledge and principles from other branches not relevant to the healthcare and reach greater results with fewer efforts made. Therefore, the cross-discipline studies should definitely be encouraged and facilitated especially in the ages of changes.

Another important insight gained from this study is that to reach better outcomes, the designers of the programs or initiative have to use the mix approach and address the problem not only from one perspective, in this case, the financial one. Of course, the widening of the context and involvement of other organizations, stakeholders, and players might be quite a cumbersome activity. Yet, as the article proves, the outcome is definitely worth that and the program designers should definitely to ensure that.

Relation to the picture

The discussed article relates to steps under consideration at least in two dimensions. First, the behavioral patterns of any society are envisaged in its culture and societal values. Affecting it, the healthcare professionals that make an attempt to bring a change might achieve the final goals. On the other hand, the behaviors as well as the biological factors are also mentioned in the step III that are referred to as the intermediary determinants or social determinants of health. Therefore, the focus f attention that has been chosen by the author of this article is the correct one since the social behaviors indeed define the health situation in the society or community of people. Affecting it through the principles mentioned in the article might lead to the change of the health state of the community residents.

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