Case Studies

Saving for Health

The saving rate for health expenses in Kenya is very low. Instead, many people wait until an emergency arrives, at which point it is often too late to find enough money, even with relying on money from friends and family. How can we shift attitudes and norms towards health saving so that people are more open to the idea of saving in advance?

Hypothesis:  We believed that some people hold inaccurate beliefs related to savings, underestimating not only the importance of saving for health but also how much others value saving for health. Previous research has shown that people perceive an event as more common or likely if it easily springs to mind (the availability heuristic). Thus, we predicted that by exposing subjects to stories of characters who experienced health emergencies and who were then relieved that they had signed up to save in advance, the subjects would be more likely to think that others value the importance of saving for health.

Experiment: We partnered with M-TIBA, a mobile health savings wallet, to test how we can shift attitudes and norms via story-telling. We created four different stories about fictional characters who were skeptical about health savings at first but were ultimately relieved that they had saved on M-Tiba which allowed them to cope with a health emergency that took place. Scripts told stories from the point of view of a father or a mother and focused on different sacrifices and benefits of saving. There was also a control condition in which subjects were not told any story. After, we asked subjects questions about how much they value saving for health as well as their perceptions of how much others in their community value saving for health. These questions were asked at three different times: 1 day before the story-telling intervention, 3 days after, and 21 days after.

Results: Different stories worked to different extents in changing attitudes and norms. Overall, the father script was shown to be most effective in changing attitudes and norms, whereas the other scripts only exhibited weak evidence of impact. For instance, those in the father script condition exhibited a stronger belief in perceiving health as important even for those who have less money even 21 days after the story-telling intervention (Fig 1). We also found evidence in the father script condition of a stronger belief in others’ valuing saving for health (Fig 2).



Application: Saving for healthcare is only one example of many ways people benefit from saving, both in the short and long term. Even saving for a generic emergency, or a “rainy day” can be an incredibly important step towards financial stability. If people are reluctant to save for emergencies because they underestimate how much others value and save for health expenses, this study demonstrates that stories could be created to influence their attitudes and perceptions of the norm. However, more research is needed to understand what key elements of the stories are most influential in changing these perceptions.