A little nudge, paid in groceries: the Western Cape rewards the healthy choice

Prevention is the cheapest medicine there is — and the hardest to get anyone to do. In Mitchells Plain, Cape Town, the Western Cape Department of Health and Wellness is trying a nudge with a payslip: WOWRewards, a pilot that pays residents up to R100 (about $6) a month in food vouchers for doing the things that keep people well — booking antenatal care, joining community exercise sessions, keeping children's immunisations up to date. The vouchers, delivered through the Zlto digital platform and redeemable at Boxer, Shoprite and Pep, can only buy food — no alcohol, no cigarettes. The design came from asking people first: a survey of more than 1,500 residents said healthy food and exercise opportunities were the rewards they actually wanted. 'Making healthy choices is not always easy. We want to give people a little extra encouragement,' said provincial health minister Mireille Wenger. The pilot expands to Knysna in early 2027, aiming to enrol 2,000 adults across urban and rural sites to learn whether the nudge works.

SDG 3 · Good health and well-being — Mechanism: behaviour campaign