Iron fortification impact on perinatal maternal mortality BOTEC

	A	B	C	D
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4	Variable	Value	Notes	Source
5	Odds ratio of maternal death during pregnancy and postpartum in severe anemia	1.86	From Daru et al. 2018: "Overall, propensity score regression analysis showed an association between severe anaemia and maternal death (adjusted OR [odds ratio] 1.86 [95% CI 1∙39–2∙49], p<0·0001; table 2)", p. 552. Since this only refers to severe anemia, it’s an upper-bound estimate. Assuming this is the same as relative risk since the two are close when a condition is uncommon.	Daru et al. 2018
6	Proportion of anemia that reflects iron deficiency	0.5	Guess based on an unpublished portion of a conversation with an expert. Anemia can also reflect infectious disease burden.
7	Adjusted “risk ratio” of maternal death during pregnancy and postpartum in severe anemia	1.43	Calculation
8	Risk of pregnancy and postpartum mortality in SSA in 2017 (annual risk averaged over all beneficiaries)	0.000088	Total population (all ages, both sexes) deaths for “maternal disorders” in Sub-Saharan Africa according to the Global Burden of Disease Results Tool = 8.75 per 100,000. This is broader than what we're specifically examining but can serve as an upper bound.	GBD Results Tool
9	Percent of women 15-49 in SSA with iron deficiency in 2017	22.6%	GBD Compare	GBD Results Tool
10	Annual risk of pregnancy and postpartum mortality in women with iron deficiency among all beneficiaries	0.000020	Calculation
11	Fraction of risk attributable to iron deficiency among deficient women	30.1%	Calculation
12	Annual risk of pregnancy and postpartum mortality attributable to iron deficiency among all beneficiaries	0.0000060	Calculation
13	Relative risk of iron deficiency with fortification	0.48	From Gera et al. 2012, a meta-analysis of iron fortification trials: "A significantly lower risk of being iron deficient was found [at the end of the fortification intervention period]...RR [relative risk]: 0.48, random-effects model; 95% CI: 0.38, 0.62; P < 0.001", p. 313	Gera et al. 2012
14	Maternal mortality risk averted per beneficiary	0.0000029	Calculation
15	Value assigned to averting the death of an individual 5 or older	85	From our main CEA, "Moral weights" sheet, cell B7.	2019 GiveWell Cost-effectiveness Analysis
16	Units of value per beneficiary	0.00024	Calculation
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19	This represents 1.2% of the total value per beneficiary currently estimated in our CEA
20	Assumptions tend to be generous
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22	Sanity check: cost-effectiveness of reducing maternal mortality by 5% via population-level intervention
23	Risk of pregnancy and postpartum mortality in SSA in 2017 (annual risk averaged over all beneficiaries)	0.000088
24	Reduction in mortality by 5%	0.000004
25	Value assigned to averting the death of an individual 5 or older	85	From our main CEA, "Moral weights" sheet, cell B7.	2019 GiveWell Cost-effectiveness Analysis
26	Units of value per beneficiary	0.00037
27	Annual cost of intervention per beneficiary (iron fortification)	$0.25	From our Fortify Health iron fortification CEA, "Model" sheet, row 14	Fortify Health iron fortification cost-effectiveness analysis
28	Units of value per $10,000	14.88
29	How many times cash?	0.39
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