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Simple CEA
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Low SDINigeria (high burden example)Notes
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Grant size$178,474$190,660
Estimated based on number of children eligible to receive free ORS and zinc, percent receiving ORS and zinc, and cost per child provided with ORS and zinc
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Child mortality benefits
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Number of children in households eligible to receive free ORS and zinc100,000100,000Arbitrary
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Cost to NGO per child provided with ORS and zinc$3$3From "CEA" tab
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Percentage point increase in number receiving ORS15ppt16pptFrom "CEA" tab
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Percent of children using ORS/zinc for diarrhea in intervention59%58%From "CEA" tab
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Mortality rate among those who do not receive ORS0.4%0.8%From "CEA" tab
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Reduction in mortality rate due to ORS60%60%From "CEA" tab
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Number of deaths averted3674Calc
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$ / death averted$4,937$2,574Calc
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Moral weight for each death averted based on age distribution of diarrheal mortality
112113From "CEA" tab
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Initial cost-effectiveness estimate713Calc
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Benefit streams (% of total)
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Child mortality benefits86%90%Calc
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Development effects7%4%From "CEA" tab
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Medical costs averted7%7%From "CEA" tab
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Additional upside and downside adjustments
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Excluded effects1.011.01From "CEA" tab
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Downstream costs to government incurred as a result of funding to NGO (leveraging)
0.800.89
Our main CEA incorporates downstream costs incurred by governments as a result of ORS. This parameter is estimated by removing any downstream costs to government and estimating how much lower cost-effectiveness is in our main CEA, compared to when these downstream costs are removed. It is a rough approximation, so there is a small difference between the final cost-effectiveness noted on this tab, and our main CEA tab. See the "No leveraging_CEA" tab for calculations.
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Chance that other funders fund similar programs with us (funging)
0.970.94
Our main CEA incorporates the probability that our funders fund ORS without our funding. This parameter is estimated by removing that possibility and estimating how much lower cost-effectiveness is in our main CEA, compared to when the possibility of funging is removed. It is a rough approximation, so there is a small difference between the final cost-effectiveness noted on this tab, and our main CEA tab. See the "No funging_CEA" tab for calculations.
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Additional benefits and adjustments0.90.9Calc
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Final cost-effectiveness (after all adjustments)6.112.2
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Comparison to peer interventions
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ORS (Nigeria)SMC (Plateau, Nigeria)Notes on SMC
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Grant size$190,660$1,000,000
Grant size arbitrary for SMC
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Main benefits
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Number targeted100,000
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Number reached57,652165,837
Number reached based on assuming ~$6 NGO costs per child reached in SMC CEA (See https://docs.google.com/spreadsheets/d/1otZFJSMM8yH5R6DkBIYmlsWy5T7VHsX_E7wDF7HSLaM/edit#gid=791021775&range=H196)
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Cost per child reached$3$6
From SMC CEA (see https://docs.google.com/spreadsheets/d/1otZFJSMM8yH5R6DkBIYmlsWy5T7VHsX_E7wDF7HSLaM/edit#gid=791021775&range=H196)
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Percentage point increase in uptake of intervention16ppt75ppt
This is based on our assumption that there's a 25% chance someone would fund this distribution without us. This is accounted for in funging in the SMC CEA. Otherwise, we'd assuming 100 pp increase in coverage and then net out funging in "additional benefits and adjustments."
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Mortality rate among recipients of intervention0.8%0.4%
From SMC CEA (https://www.google.com/url?q=https://docs.google.com/spreadsheets/d/1otZFJSMM8yH5R6DkBIYmlsWy5T7VHsX_E7wDF7HSLaM/edit%23gid%3D791021775%26range%3DH64&sa=D&source=editors&ust=1686765621334549&usg=AOvVaw2pU8AxoHkiSJ79iNWWobug)
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Reduction in mortality from intervention60%55%
From SMC CEA. This includes adjustments for IV, EV, protection only during rainy season, etc.
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Number of deaths averted74241Calc
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$ / death averted$2,574$4,154Calc
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Moral weight for each death averted113116
From SMC CEA (See this row: https://docs.google.com/spreadsheets/d/1otZFJSMM8yH5R6DkBIYmlsWy5T7VHsX_E7wDF7HSLaM/edit#gid=791021775&range=A70)
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Initial cost-effectiveness estimate138Calc
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Additional benefits and adjustments0.91.7
In the case of SMC, this is primarily development benefits and effects on untreated. These constitute ~30% of overall benefits (~25% dev, ~5% untreated), so lead to a 1.4x multiplier on their own. See these two rows in our SMC CEA: https://docs.google.com/spreadsheets/d/1otZFJSMM8yH5R6DkBIYmlsWy5T7VHsX_E7wDF7HSLaM/edit#gid=791021775&range=A131:A132. Other adjustments include downside adjustments, excluded effects, and leverage and funging adjustments
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Final cost-effectiveness (after all adjustments)1214Calc
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