title: Innovative business approaches for incenting health promotion in sub-Saharan Africa: progress and persisting challenges.
abstract: Non-communicable chronic diseases related to behaviors such as tobacco use, overeating, excess alcohol intake and physical inactivity account for increasing morbidity and mortality in South Africa. Over the last 15 years, Discovery Health, the largest private health plan in South Africa, has developed a voluntary health promotion program called Vitality with over 1.5 million members. Vitality was designed with many applications drawn from the growing field of behavioral economics, including the use of incentives and rewards. Incentives offered on the program are aimed at lowering the financial barriers to activities such as visiting the gym, buying healthy food or receiving preventive screening. Members accrue points for engagement which translate into discounts on a range of goods and services. Although the full impact of the program cannot yet be quantified, engagement with the program is continually increasing and there is compelling evidence that this translates into better health and cost outcomes.
authors.affiliation: Discovery Vitality, Johannesburg, Sandton 2156, South Africa.
authors.forename: Deepak N
authors.initials: DN
authors.lastname: Patel
authors.forename: Craig
authors.initials: C
authors.lastname: Nossel
authors.forename: Eleanore
authors.initials: E
authors.lastname: Alexander
authors.forename: Derek
authors.initials: D
authors.lastname: Yach
mesh_terms: D017954:Africa South of the Sahara; D003695:Delivery of Health Care / Q000191:economics*; D003906:Developing Countries; D006293:Health Promotion / Q000191:economics* / Q000639:trends*; D006801:Humans
keywords: AIDS; Behavioral economics; HIV; Health plan; Health promotion program; Incentives; NCD; Non-communicable chronic diseases; SA; South Africa; USA; USDA; United States Department of Agriculture; United States of America; acquired immunodeficiency syndrome; human immunodeficiency virus; non-communicable diseases