Just a quick question: You write that the cost for 1 year free from IPV is about US$194, and that this means the intervention costs US$78.4/DALY
If I understand this correctly, it would mean that 1 year free from IPV is about 2.5 DALYs? Is that correct? It seems to imply that experiencing IPV is worse than death… which might well be true, but the more likely explanation is that I misunderstand the DALY conversion. Could you clarify?
Great question :) So this model used accounts for multiple different types of alleviated health burden from each year free from IPV. Specifically, each year free from IPV prevents chronic conditions that cause disability that lasts many years, femicide, as well as acute issues within that year itself. That would explain why 1 year free from IPV can be more than 1, and in this case roughly converts to 2.5 DALYs.
Thank you for the explanation! I sincerely appreciate, since I realized that my question could be perceived as trolling or nitpicking on the cost-effectiveness estimates. My intention is rather to understand better the impact of these interventions. Also, these DALY calculations are just hard (at least for me).
I think the answer makes sense.
Do you have a reference to the model that you’ve used (pardon if I missed the link)? I would be interested to look at it in a bit more detail. For example, my gut feeling is that a single or a few instances of IPV might already cause chronic damages; and so to avoid this damage we would be interested more in IPV-free lives than IPV-free years.
EDITED to add: On the other hand, it would seem likely that the effect of an intervention lasts for longer than a year, and thus that the beneficiaries would benefit from a reduced IPV risk for much of their lives.
A clarification, after having read more about the interventions:
The studies asked women whether they experienced various forms of intimate partner violence over the last year. If a woman reported any form of violence, that was coded as a “case of IPV”. Multiple or repeated experiences within the last year do not change the coding, it is still just one “case of IPV”. The “Unite for a better life” intervention averts one case per US$194.
This means one woman more who did not experience violence in the last year. Which probably also means that she is in a lower-risk relationship, and that this state will persist for some time in the future.
Just a quick question: You write that the cost for 1 year free from IPV is about US$194, and that this means the intervention costs US$78.4/DALY
If I understand this correctly, it would mean that 1 year free from IPV is about 2.5 DALYs? Is that correct? It seems to imply that experiencing IPV is worse than death… which might well be true, but the more likely explanation is that I misunderstand the DALY conversion. Could you clarify?
Great question :) So this model used accounts for multiple different types of alleviated health burden from each year free from IPV. Specifically, each year free from IPV prevents chronic conditions that cause disability that lasts many years, femicide, as well as acute issues within that year itself. That would explain why 1 year free from IPV can be more than 1, and in this case roughly converts to 2.5 DALYs.
Thank you for the explanation! I sincerely appreciate, since I realized that my question could be perceived as trolling or nitpicking on the cost-effectiveness estimates. My intention is rather to understand better the impact of these interventions. Also, these DALY calculations are just hard (at least for me).
I think the answer makes sense.
Do you have a reference to the model that you’ve used (pardon if I missed the link)? I would be interested to look at it in a bit more detail. For example, my gut feeling is that a single or a few instances of IPV might already cause chronic damages; and so to avoid this damage we would be interested more in IPV-free lives than IPV-free years.
EDITED to add: On the other hand, it would seem likely that the effect of an intervention lasts for longer than a year, and thus that the beneficiaries would benefit from a reduced IPV risk for much of their lives.
A clarification, after having read more about the interventions:
The studies asked women whether they experienced various forms of intimate partner violence over the last year. If a woman reported any form of violence, that was coded as a “case of IPV”. Multiple or repeated experiences within the last year do not change the coding, it is still just one “case of IPV”. The “Unite for a better life” intervention averts one case per US$194.
This means one woman more who did not experience violence in the last year. Which probably also means that she is in a lower-risk relationship, and that this state will persist for some time in the future.