To what degree should we rely on volunteers to get the work done in ending maternal and child deaths?

By November 8, 2010 8 Comments

I think the evidence we are seeing on Care Groups is proof that there’s a large role for community-level volunteers in bringing about the sort of changes that we want to see and that are necessary for ending child deaths. But it goes beyond that. It’s not just that volunteers are the best way to stretch a rupee or dollar. Not paying people can lead to better performance on some tasks than paying them. There’s recent evidence that for simple, straightforward tasks that only require mechanical skills, monetary rewards work great: Higher pay = better performance. But when a task gets more complicated, when it requires even rudimentary cognitive skills, larger monetary rewards lead to poorer performance. This is not a hunch. This is based on research by economists at MIT, Univ of Chicago, and Carnegie Mellon (funded by the Federal Reserve), and has been replicated in developing country settings. And in my opinion, the persuasive, thinking on your feet, working-around-barriers work that we need people to do to promote behavior change is far from a mechanical skill. This health promotion work – when it’s kept light and not burdensome – also has a high non-monetary pay-off for the volunteer in terms of some of the things which do motivate people: achieving mastery, having autonomy, and gaining purpose through what they do.

Another lesson that I take away from this work is that paying “a little something” can often hurt productivity and results.  Imagine if you had a neighbor who asks you for a ride to the store, but then insists that they pay you $1 for it.  Are you more likely to take them?  Many times, these small offers of monetary incentives actually turn us off, and they can make us process the request differently, looking at cost-benefit rather than drawing on our other (higher?) motivations.  With Care Groups, no monetary incentives are given to the Care Group volunteers (who do 80% or more of the actual work) and we have seen that even the non-monetary (but tangible) incentive of a $5 wrap-around skirt each year (with health messages on them) often cause more problems than they resolve, and programs can be entirely successful without them.  (Now we should be thinking creatively about how we can help volunteers to offset the time they spend on this work, like giving them time-saving things [e.g., pressure cookers?] that decrease their time burdens at home.)  In short, we were never just Homo Economicus, completely rational and narrowly self-interested, economically-driven actors.  We are so much better than that, and I have always found that those old models that look at people that way are dehumanizing, quite incomplete, and need to be jettisoned.

But don’t take my word for it: Watch this entertaining video presentation by Daniel Pink (author of Drive) on this new line of research. Think about what this means for you, your organization and how you do your projects, and add a comment below.  Warning:  If you are 50 or older (like me), you might want to move your screen away from you about two feet.  It move very quickly, and otherwise you might get nauseas. : )  Click the arrows in the bottom-right corner to see if full-screen.


And by the way, if you are asking yourself where I get the motivation to maintain this site and write these blogs, I’ll give you a hint — no one’s paying me. : )  Something deeper is going on.

— Tom Davis

Senior Specialist for Social & Behavioral Change, TOPS Project
Senior Program Director, Program Quality Improvement, Food for the Hungry


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Join the discussion 8 Comments

  • Diana DuBois says:

    Very interesting! We have worked with community-level volunteers in numerous countries for the past 30 years with great success. We have experienced challenges, however, if another group comes into the same or an adjoining district and offers to pay the community-level ‘volunteers’ a significant amount.

  • Phil Moses says:

    Great video. Raises some very interesting questions about how to design and (especially) run programs.

  • Mary DeCoster says:

    Tom, great stuff! this explains a lot!!! (Drive video).

    It looks like you are doing amazing stuff! the curricula look awesome too! I should’ve volunteered on the curricula with you all. getting paid did make it less satisfying. that’s so weird.

    hope all is well with you.

    with love and appreciation for all you do,


  • Chad Swanson says:

    Excellent. Thanks for the link, Tom.

    I’m seeing some parallels with systems thinking, which goes something like this: independent agents in complex, adaptive systems make choices to sacrifice if they share a vision (“future they want to create”) with others in the system/organization.

  • tdavismph says:

    Diana: That’s true, and one thing that probably needs to happen more is to educate people about these principles, and how it disrupts things when organizations pay people “a little something.”

  • Yolanda Barbera says:

    This is a really inspiring video. The International Rescue Committee has been working with community health volunteers for a long time and believes that payment doesn’t translate in better performance.

  • Terry Laura says:

    the first comment brought back of an earlier experience in Kenya during the 80s where one group paid their pastors $50 a month and our organization gave nothing. we had a motivated group of men and women and they had many struggles. Interesting.

  • Tom Davis says:

    What incentives work to get US doctors to move to remote locations and practice? How about the option to spend eight weeks in Haiti volunteering their time? See this link for more on appealing to a person’s desire for AUTONOMY and a higher PURPOSE and as incentive. http://www.npr.org/blogs/health/2012/02/02/145860801/how-one-hospital-entices-doctors-to-work-in-rural-america?sc=17&f=1001 — Tom