A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | |
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1 | Cost | Notes | ||||||||||||||||||||||||
2 | Intervention cost per pregnant woman treated | $7.33 | ||||||||||||||||||||||||
3 | Hypothetical cohort | 10,000 | Arbitrary. Changing this value does not affect the bottom line estimates. | |||||||||||||||||||||||
4 | Cost to treat cohort | $73,300 | ||||||||||||||||||||||||
5 | ||||||||||||||||||||||||||
6 | Maternal anemia reduction | |||||||||||||||||||||||||
7 | Proportion of cohort with anemia | 100% | Estimate hack: "Over 50% of pregnant women in LMICs suffer from anaemia" Salam 2015, Pg 1 | |||||||||||||||||||||||
8 | RR of anaemia with intervention | 0 | Assumed upper bound of 28% reduction (based on custom meta-analysis) | |||||||||||||||||||||||
9 | Internal validity adjustment | 100% | Generally strong internal validity across included RCTs, as vetted by other meta-analysis researchers and qualitatively/briefly by GiveWell | |||||||||||||||||||||||
10 | External validity adjustment | 100% | Reduced 20% (percentage is very arbitrary) due to iheterogenity in programs (e.g., iron supplementation) and effects (I^2=83%) | |||||||||||||||||||||||
11 | RR of anemia with intervention adjusted for internal and external validity | 0.00 | ||||||||||||||||||||||||
12 | Proportion of population 'cured' of anemia | 100% | ||||||||||||||||||||||||
13 | YLD burden of a year of moderate anemia | 0.052 | 2013 GBD weights from Salomon et al (2015) - Table 2. | Chris has some additional thoughts on DALY weights for anemia here. | Further thoughts on DALY weights for anemia here: https://docs.google.com/document/d/10m2ZcYfmjjl3fFU-6kw6bXyjFz-YV57HKz3eULw309o/edit#heading=h.gi5pd1pem8ui | |||||||||||||||||||||
14 | Total anemia YLDs averted in cohort | 520.0 | ||||||||||||||||||||||||
15 | ||||||||||||||||||||||||||
16 | Cost per anemia YLD averted | $141 | ||||||||||||||||||||||||
17 | Anemia YLDs averted per $10,000 | 70.94 | ||||||||||||||||||||||||
18 | ||||||||||||||||||||||||||
19 | Newborn anemia reduction | |||||||||||||||||||||||||
20 | Proportion of cohort with anemia | 100% | Assuming 1:1 with mother | |||||||||||||||||||||||
21 | RR of anaemia with intervention | 0 | Assuming 1:1 with mother | |||||||||||||||||||||||
22 | Internal validity adjustment | 90% | Generally strong internal validity across included RCTs, as vetted by other meta-analysis researchers and qualitatively/briefly by GiveWell | |||||||||||||||||||||||
23 | External validity adjustment | 80% | Reduced 20% (percentage is very arbitrary) due to iheterogenity in programs (e.g., iron supplementation) and effects (I^2=83%) | |||||||||||||||||||||||
24 | RR of anemia with intervention adjusted for internal and external validity | 0.28 | ||||||||||||||||||||||||
25 | Proportion of population 'cured' of anemia | 72% | ||||||||||||||||||||||||
26 | YLD burden of a year of moderate anemia | 0.052 | 2013 GBD weights from Salomon et al (2015) - Table 2. | Chris has some additional thoughts on DALY weights for anemia here. | Further thoughts on DALY weights for anemia here: https://docs.google.com/document/d/10m2ZcYfmjjl3fFU-6kw6bXyjFz-YV57HKz3eULw309o/edit#heading=h.gi5pd1pem8ui | |||||||||||||||||||||
27 | Total anemia YLDs averted in cohort | 374.4 | ||||||||||||||||||||||||
28 | ||||||||||||||||||||||||||
29 | Cost per anemia YLD averted | $196 | ||||||||||||||||||||||||
30 | Anemia YLDs averted per $10,000 | 51.08 | ||||||||||||||||||||||||
31 | ||||||||||||||||||||||||||
32 | Newborn cognitive benefits | |||||||||||||||||||||||||
33 | Proportion of newborn with anemia at baseline | 100% | Assuming 1:1 with mother | |||||||||||||||||||||||
34 | Change in intelligence quotient from intervention | 33% | 0.25 SD in Sachdev et al (2005), 0.33 SD in Low et al (only for anemic children), ~0.25 for other cognitive tests in Christian et al (2010) | |||||||||||||||||||||||
35 | Percentage increase in wages/consumption for every 1 point increase in IQ | 1.00% | Same methodology as in the GiveWell's iodine CE estimate, using information from DCP2, 'Economic Benefits of Long-Term Improvements in IQ' section here: https://www.ncbi.nlm.nih.gov/books/NBK11783/ | |||||||||||||||||||||||
36 | Speculative adjustment to assess the long-term benefit of many years of iron | 10.00% | We see increases in IQ after supplementation for less than 1 year. It could be that there's a linear effect (e.g. one year of supplementation raises IQ by 5 points, 2 years raises IQ by 10 points). That's extremely implausible though. More likely, going from low haemoglobin levels to normal haemoglobin levels leads to an IQ increase of a couple points. I would guess that those cognitive benefits remain as long as someone is non-anemic and mostly disappear if haemoglobin levels return to the initial low levels. More details here: https://docs.google.com/document/d/15ifHdYl-mI6ZF_SgksADD3myusxya3ZBYrPHLKt9_ao/edit?usp=sharing | |||||||||||||||||||||||
37 | Percentage increase in wages/consumption from increase in IQ from supplementation | 0.50% | Definitional—1 sd of IQ = 15 points | |||||||||||||||||||||||
38 | Increase in annual ln(consumption) for beneficiaries | 0.0049 | ||||||||||||||||||||||||
39 | ||||||||||||||||||||||||||
40 | Internal validity adjustment | 70% | Weak to moderate quality evidence base | |||||||||||||||||||||||
41 | External validity adjustment | 40% | Discount by ~50% for arguments about why short-term benefits may not extend to long-term; discount by ~20% for arguments related to external validity (anemia was more severe in studies on effects of IQ than in this target population). More details here: https://docs.google.com/document/d/10m2ZcYfmjjl3fFU-6kw6bXyjFz-YV57HKz3eULw309o/edit#heading=h.n5l1r9eaukrc and here: https://docs.google.com/document/d/12Wl1EKFoKa1GpiDNhw1umfpUGObHY1vUZGWZB6buZms/edit | |||||||||||||||||||||||
42 | ||||||||||||||||||||||||||
43 | Adjusted increase in annual ln(consumption) for beneficiaries | 0.0014 | ||||||||||||||||||||||||
44 | Average increase in annual ln(consumption) in cohort (including non-beneficiaries) | 0.0014 | ||||||||||||||||||||||||
45 | Average number of years between 'entering fortification program' and beginning of long term benefits | 16.40 | Assumes earnings begin at 16 years and a midpoint intervention age of -4.5 months (halfway through pregnancy) | |||||||||||||||||||||||
46 | Discount rate | 3.00% | Copied directly from "Early life growth intervention BOTEC", could customize for future iterations | |||||||||||||||||||||||
47 | Duration of long term benefits of fortification (in years) | 30 | Median duration of benefits for deworming was 30 in GiveWell CEA, Nov 2016 | |||||||||||||||||||||||
48 | ||||||||||||||||||||||||||
49 | Present value of sum of average lifetime income benefits (including non-beneficiaries) | 0.0167 | ||||||||||||||||||||||||
50 | Multiplier for resource sharing in households (beneficiaries will eventually have children) | 200% | Consistent with the multiplier used in GW's 2018 V1 deworming CEA | |||||||||||||||||||||||
51 | Sum of lifetime income benefits per individual in cohort, accounting for resource sharing | 0.033 | ||||||||||||||||||||||||
52 | Total lifetime income benefits for full cohort, in terms of ln(income) | 333.78 | ||||||||||||||||||||||||
53 | Units of increase in ln(income) per $10,000 | 45.54 | ||||||||||||||||||||||||
54 | ||||||||||||||||||||||||||
55 | Reaching a common unit for comparison | |||||||||||||||||||||||||
56 | Moral weights | |||||||||||||||||||||||||
57 | Value of 1 YLD | 1 | Arbitrary starting point | |||||||||||||||||||||||
58 | Value of doubling consumption for one person for one year | 1 | https://docs.google.com/spreadsheets/d/1zLmPuddUmKsy3v55AfG_e1Quk-ngDdNzW-FDx0T-Y94/edit#gid=1362437801&range=B3 | |||||||||||||||||||||||
59 | Value of increasing ln(consumption) by one unit for one person for one year | 1.44 | ||||||||||||||||||||||||
60 | ||||||||||||||||||||||||||
61 | Units of value per $10,000 | |||||||||||||||||||||||||
62 | Units of value from maternal anaemia YLDs averted | 70.9 | ||||||||||||||||||||||||
63 | Units of value from newborn anaemia YLDs averted | 51.1 | ||||||||||||||||||||||||
64 | Units of value from income benefits from newborn cognitive effects | 65.7 | ||||||||||||||||||||||||
65 | Overall units of value per $10,000 | 187.7 | ||||||||||||||||||||||||
66 | ||||||||||||||||||||||||||
67 | Comparison to cash | |||||||||||||||||||||||||
68 | GiveDirectly units of increase in ln(consumption) for each $10,000 donated | 25.2 | See Row 21, Sheet "Cash", here: https://docs.google.com/spreadsheets/d/1mUbO8D5hWKn8nM3a2ZtD6zrRFP83LN5HBQzxXOarbM4/edit#gid=1680005064 | |||||||||||||||||||||||
69 | Units of value per $10,000 from GiveDirectly | 36.4 | ||||||||||||||||||||||||
70 | Deworming for pregnant women is X times as cost-effective as GiveDirectly | 5.2 | ||||||||||||||||||||||||
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