I’m not sure yet whether I’m on board, and in order to know the answers I would need more information.
IMPACT: not only how widespread is the experience of not being treated with dignity, but also how bad is it? I feel that my bank treats me with indignity as a matter of course, so we need some way to factor in severity of indignity, and we shouldn’t accidentally take the prevalence of all cases of indignity (severe or otherwise) and then multiply them by the most severe severity and end up with an overestimate
TRACTABILITY: “Dignity is also highly solvable <...> include potentially highly cost-effective interventions such as listening” I think the tractability claim needs more substantiation. Me choosing to listen more is cheap. However if I pay you to get corrupt officials in the developing world to be better active listeners, I would predict poor cost-effectiveness because it probably wouldn’t work, I would guess.
NEGLECTEDNESS: Defining the interventions better will help us better assess neglectedness. However at first glance it seems that it’s probably not neglected. If we survey lots of aid professionals and asked them “Do you want your colleagues and the aid sector as a whole to treat beneficiaries with respect” I predict that a very high proportion will say yes. However if I had a clearer picture of your action plan, I might conclude that your particular approach may well be neglected
Of these, I think the first (impact) is the most important. Any concerted effort on the topic of dignity will inevitably have opportunity costs, so we need to understand why it’s more important than some other factors.
Thank you again for raising a fresh idea. The questions I’m raising are intended to be positive and encouraging.
I think your caution on how we could easily overestimate our impact is right. We have good evidence that disrespect is common. In a study with 239 participants from Kibera in Nairobi, a one-unit increase in disrespect score was associated with a reduction on the wellbeing scale of 0.2, and a reduction in the self-efficacy scale of 0.3 (both significant at p=>0.01) - that’s suggestive, but not precise enough yet. Something for a wider study at some point!
On tractability, I think I see more promise. Charities are well-practiced at implementing changes to their processes for whatever reason, and well-defined recommendations could be taken up by their teams fairly easily. Even in the admittedly harder case of changing government practice, there are papers suggesting that day-long training sessions can have solid impacts (apologies, can’t find the reference this morning).
Neglectedness, as you say, depends on exactly the level of action we are asking for. As you say many would offer a rhetorical commitment to dignity (in a recent survey, 79% of 407 US non-profit professionals personally committed to raising dignity as an issue where they could do better, with their colleagues. My impression though is that this isn’t enough to actually change practice—there’s a gap between that rhetorical commitment and the frequent experiences of disrespect reported by those who take part in those programs.
Thank you for raising this topic.
I’m not sure yet whether I’m on board, and in order to know the answers I would need more information.
IMPACT: not only how widespread is the experience of not being treated with dignity, but also how bad is it? I feel that my bank treats me with indignity as a matter of course, so we need some way to factor in severity of indignity, and we shouldn’t accidentally take the prevalence of all cases of indignity (severe or otherwise) and then multiply them by the most severe severity and end up with an overestimate
TRACTABILITY: “Dignity is also highly solvable <...> include potentially highly cost-effective interventions such as listening” I think the tractability claim needs more substantiation. Me choosing to listen more is cheap. However if I pay you to get corrupt officials in the developing world to be better active listeners, I would predict poor cost-effectiveness because it probably wouldn’t work, I would guess.
NEGLECTEDNESS: Defining the interventions better will help us better assess neglectedness. However at first glance it seems that it’s probably not neglected. If we survey lots of aid professionals and asked them “Do you want your colleagues and the aid sector as a whole to treat beneficiaries with respect” I predict that a very high proportion will say yes. However if I had a clearer picture of your action plan, I might conclude that your particular approach may well be neglected
Of these, I think the first (impact) is the most important. Any concerted effort on the topic of dignity will inevitably have opportunity costs, so we need to understand why it’s more important than some other factors.
Thank you again for raising a fresh idea. The questions I’m raising are intended to be positive and encouraging.
Thanks Sanjay for these responses.
I think your caution on how we could easily overestimate our impact is right. We have good evidence that disrespect is common. In a study with 239 participants from Kibera in Nairobi, a one-unit increase in disrespect score was associated with a reduction on the wellbeing scale of 0.2, and a reduction in the self-efficacy scale of 0.3 (both significant at p=>0.01) - that’s suggestive, but not precise enough yet. Something for a wider study at some point!
On tractability, I think I see more promise. Charities are well-practiced at implementing changes to their processes for whatever reason, and well-defined recommendations could be taken up by their teams fairly easily. Even in the admittedly harder case of changing government practice, there are papers suggesting that day-long training sessions can have solid impacts (apologies, can’t find the reference this morning).
Neglectedness, as you say, depends on exactly the level of action we are asking for. As you say many would offer a rhetorical commitment to dignity (in a recent survey, 79% of 407 US non-profit professionals personally committed to raising dignity as an issue where they could do better, with their colleagues. My impression though is that this isn’t enough to actually change practice—there’s a gap between that rhetorical commitment and the frequent experiences of disrespect reported by those who take part in those programs.