Price is one of the most powerful instruments a manager can use to influence the take-up of her product, especially in a subsidized and noncompetitive market as is common for global health products. However, the question of whether and how to price has been the subject of extensive policy debate: whether to charge users for life-saving health products and services, whether to distribute them for free, or whether to give additional incentives for individuals to use them. This note describes the latest, cutting-edge, research on how pricing influences the end user's decision to purchase and use vitally needed health products, opening a deeper and informed dialogue about pricing. The note concludes with a succinct guide to how to optimally price products based on different organizational goals and product characteristics.

Why doesn't a woman who continues to have unwanted pregnancies avail herself of the free contraception at a nearby clinic? What keeps people from using free chlorine tablets to purify their drinking water? Behavioral economics has shown us that we don't always act in our own best interests. This is as true of health decisions as it is of economic ones. An array of biases, limits on cognition, and motivations leads people all over the world to make suboptimal health choices. The good news is that human nature can also be a source of solutions. Through her studies in Zambia exploring the reasons for unwanted pregnancies and the incentives that would motivate hairdressers to sell condoms to their clients, the author has found that designing effective health programs requires more than providing accessible, affordable care; it requires understanding what makes both end users and providers tick. By understanding the cognitive processes underlying our choices and applying the tools of behavioral economics--such as commitment devices, material incentives, defaults, and tools that tap our desire to help others--it's possible to design simple, inexpensive programs that encourage good health decisions and long-term behavior change.

This case describes barriers to adoption of malaria rapid diagnostic tests in Zambia and highlights the importance of understanding end users in promoting product adoption. Rapid diagnostic tests (RDTs) are simple, easy-to-use tools that provide a relatively reliable, inexpensive way to confirm diagnoses of malaria. In addition to ensuring that patients' febrile illnesses are properly diagnosed and treated, confirming malaria diagnoses has broader public health benefits, including promoting the efficient use of limited malaria medications and preventing increased resistance to first-line malaria treatment. However, despite the evident potential benefits of RDTs, many clinicians in Zambia do not use them or simply ignore their results. Why don't they trust these tools, and what can be done to improve adoption? Various barriers to uptake and methods to overcome these challenges are explored, with broad implications for technology adoption and health policy. A particular emphasis is placed on the role of behavioral preferences.

This case highlights the puzzlingly high rate of diarrhea-related child mortality in developing countries despite the existence of a simple, effective treatment: oral rehydration therapy (ORT). ORT treated extreme dehydration caused by diarrhea, which was a leading cause of death among young children in developing countries, particularly in Africa and Asia. Heralded in the 1970s as one of the most important medical advancements of the 20th century, ORT contributed to a reduction in diarrhea-related child deaths from roughly 4.5 million in 1980 to 1.5 million in 2000. Yet for reasons unclear to the global public health community, the mortality rate stalled at around 1.5 million, where it remained in 2010. In presenting the problem of diarrhea-related death, the solution represented by ORT, and the various factors potentially influencing ORT utilization, the case allows students to analyze the possible causes of low ORT utilization and potential measures to address them.

Karen Levy and her colleague, Margaret Ndanyi, have spent the last six months planning and preparing for a national Kenyan program to target school children most at risk for parasitic worm infection. One week after its launch, the program seemed to be going well but Ndanyi and Levy knew that it still needed to be administered in almost 40 districts at thousands of schools. They wondered: Would they meet their goal of deworming over three million school children before the end of the fiscal year on June 30, 2009? Would they be able to do it for less than $0.50 per child?

Karen Levy and her colleague, Margaret Ndanyi, learn the results of their nation-wide effort to rid Kenyan school children of parasitic worm infection.

Roll Back Malaria, a global partnership dedicated to fighting malaria has not met its founders' expectations of effectively combatting malaria. In 2005, after several internal evaluations, RBM leadership has decided to engage the Boston Consulting Group to work on a Change Initiative that when completed will enable RBM to address the eradication of malaria both more effectively and through larger scale efforts. However, the Initiative has become derailed after BCG's first major presentation to the RBM board. Will this end the Change Initiative prematurely?

This case examines the various considerations relevant to selecting and compensating workers in a context where their work involves a pro-social component. This is relevant to not only health care in Zambia, but to NGO and public sector workers who are both motivated by the mission of their positions and the remuneration. Zambia was facing a healthcare human resource crisis with less than half of the healthcare workers needed to meet health needs. Yet, it was simultaneously burdened by high incidence of diseases such as HIV/AIDS, TB, malaria, malnutrition, and respiratory and diarrheal diseases. The Zambian Ministry of Health (MoH) realized that in the short term, it would be impossible to train the number of doctors and nurses needed to fill this gap. Thus, they were considering incorporating the primarily volunteer community health worker (CHW) force into salaried health workers of the MoH. Given the high level of personal commitment and dedication combined with the proper education and skill needed to be an effective community health worker, the MoH was struggling to identify the best strategy to recruit and retain motivated and capable CHWs.

Green Bank of the Philippines was known for its product innovation and its ability to bring new products to market. In 2002, Green Bank designed an untested commitment savings product that both gave individuals access to formal savings and helped them commit to reaching their savings goals. Omar Andaya, the Green Bank president, must decide how to evaluate the success of this product. The management team at Green Bank discusses various evaluation methods, including a formal quantitative impact evaluation using a randomized control trial (RCT), and the value an impact assessment brings to the Bank. In particular, they grapple with the question of how success is measured for a product both for the bank and for its clients. The case highlights the issues an organization must consider before deciding to do an impact assessment as well as common design challenges.

Senior management at PSI, arguably the world's largest and most successful social marketer with impressive achievements in the field of family planning, HIV/AIDS, and malaria prevention must determine what to do about their slow-to-take-off clean water initiative. PSI's point-of-use products offered effective protection against water-borne diseases, especially diarrhea, yet the organization found it hard to attract donor funds to sustain the initiative. Its managers must determine how to alter their strategy going forward.