The Mbrella Calendar: Helping Kenyan Families Track Their Savings for Health Insurance
Mbrella is a charitable organization devoted to helping impoverished Kenyan families buy health insurance. Mbrella connects donors with Kenyan mothers and over time, employs a number of behavioral interventions meant to help the mother gain enough financial stability to be able to afford insurance for the family on her own. One such intervention is the Mbrella Calendar, which was designed with a number of behavioral insights in mind. The calendar is meant to help Kenyan mothers overcome barriers such as lack of social support, an environment designed with temptation and instant gratification at its core, and the basic difficulty of keeping track of one’s progress, which can all derail good intentions.
In designing the calendar, we first wanted to tackle issues of social support. In order to do this, we sought to engender a sense of collective responsibility within the family. Typically, mothers are in charge of healthcare for the household, but fathers tend to be in charge of finances. Rather than putting all of the responsibility on one member of the family, we wanted the family to see itself as a group reaching towards a collective goal. At the very top of the calendar, we have “Team [family surname]’s Savings Calendar” written, where the family will write in their name. This is designed to encourage family members to think of this as a goal that the family will be pursuing as a unit. Also, at the top of the calendar, there is a story that outlines a hypothetical family’s savings journey with Mbrella – which demonstrating the importance of having the entire family save for health insurance.
Typically, mothers are in charge of healthcare for the household, but fathers tend to be in charge of finances.
The next design feature leverages prior work demonstrates that developing concrete plans leads to a higher likelihood of goal achievement. We have included boxes over the days of the week so that families can choose on which days they intend to save. Underneath the calendar itself, we have instructions for how to save for insurance using the mobile M-TIBA wallet (including the relevant account and phone numbers needed to save), and keep track of savings using the calendar. Even something as simple as forgetting your account number can act as a significant barrier to action, so it is important to provide easily accessible reminders.
Finally, at the bottom of the calendar we have a gamified savings system that helps families track savings each month while also providing an element of fun. Football (soccer) is a very popular sport in Kenya, so we thought creating a tracking system that mimicked a football match could help to involve the children in the savings process. Hopefully, by involving the children, we can reinforce the value of saving for health insurance for the parents, and provide a model of savings behavior for those children as they grow up. Families are also given a sheet of stickers with football stickers for each month that they need to save. One sticker represents 10 Kenyan Shilling. Each time they save, they will add a football (or multiple footballs if they save more than 10 Shilling at a time) to the football field tracking their progress from one end of the field to the goal. Along the way, we have added “defenders” that need to be avoided, which are pictures of temptations (e.g., clothes, fast food, soda) that Kenyans have reported wanting to cut down on to reduce spending.
On the sticker sheet, we have photos of each temptation, with a corresponding number of footballs that each temptation would cost. This should help members think in terms of health insurance savings when dealing with temptation. Reaching the goal means that a family has successfully saved for a month. If the family fails to reach their goal for a month, they will be given a fresh start when they flip the calendar to the next page. Fresh starts can provide a renewed motivation towards a goal, focusing them on the future rather than the past. Finally, whereas the football field acts as a short time-scale tracker and is meant to be the primary area of focus for the family, the sticker sheet also acts as a tracker towards the ultimate goal, as individuals can determine how far they need to go to reach their final goal by counting the number of stickers left on the sheet.
When it comes to helping families save for health insurance, Mbrella wants each of its interventions to tackle as many potential barriers as possible. The Mbrella calendar epitomizes this approach by providing solutions for socio-cultural and individual barriers. Whereas the calendar seeks to solve a number of problems, no one intervention can do it all. This is why Mbrella is rolling out several behavioral interventions over time which will be integrated with the calendar to help support the savings system set up by the calendar and tackle issues not accounted for by the calendar intervention. If you are interested in finding out more about the behavioral interventions being used by MBrella or if you like the idea of supporting families as they work towards being able to buy insurance on their own, please visit the Mbrella site.
Jonathan Corbin is a Senior Behavioral Researcher at the Center for Advanced Hindsight at Duke University, an applied behavioral science research lab that helps people be happier, healthier, and wealthier. You can reach him at firstname.lastname@example.org
Is your organization in any other way interested in health research with CAH? Contact Jan Willem Lindemans, Principal, at email@example.com.