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In addition to the $3.9M grant, there’s also a more recent $15M grant to scale up.
I was surprised to read that GiveWell estimates the value of “averting stillbirth or miscarriage” at 21 (where 1 is the value of doubling someone’s income for 1 year) and the value of averting a stillbirth at 33 based on a survey of “70 of our largest donors”, sadly it seems that they didn’t have beneficiaries survey data on the value of preventing stillbirths.
That’s more than what I would have guessed (for reference, the value of “preventing one 5-and-over death from malaria” is 83).
Thankyou for this- I’ve updated the post. I think this particular narrow intervention (adding syphilis testing to routine HIV screening programmes) is super exciting.
Interesting. What would your guess have been? My instinct is that people will have a very wide range of intuitions on this, at least until we’re able to be a bit more specific about what we’re asking for- even then, I expect quite a high degree of variance in how much people value averting a stillbirth. I don’t have a strong opinion myself on what the right number is.
I agree with this, and I think this might be a case where the largest donors, median donors, and beneficiaries might have very different intuitions.
Very low confidence, but my central estimate would have been closer to 10, when asking beneficiaries, but it’s a baseless wild guess based on nothing.
Agreed that this seems very possible. Who should we listen to most closely if it is the case?
Why is the rate in ocean Oceania so low? I would naively have expected it to be decent but not as good as in richer parts of the world? Is “no data” being coded as “zero occurrence”?
That’s not a per capita rate, it’s a total count. The population of Oceania excluding Australia and New Zealand is really small.
Thanks! I missed that it was absolute. A rate would make more sense, though I guess absolute numbers do tell us the size of the opportunity.
I am not clear from your explanation on whether health impacts are talking about the effect on the mother or the effect on the stillborn child. If you are considering the effect on the stillborn child, it seems that you should consider increasing reproduction as approximately as good as decreasing stillbirths.
It seems to me that you have to accept one of these or the other. Treating a failed conception as ~0 DALYs but a stillbirth as ~5 DALYs doesn’t make any sense to me. Either they should both be ~0, or they should both be ~70. But if the 5 DALYs number is the effect on the mother, then that’s fair. (Although I’m guessing the effect on the mother would be much smaller than that?)
(I have no comment on the rest of the investigation as it’s somewhat technical and outside of my expertise. It looks like you’re looking at the right questions, at least.)
Hi Michael. Thanks for your thoughtful comment.
You’ve highlighted an issue I agree with- that this is something of a grey area where one’s personal position on complex moral issues can make a big difference to how effective you think this problem area might be.
In the article, I’m defining the health impacts of a stillbirth as the years of health, or healthy life, lost to the child who is stillborn- this, as you point out, is very hard to define. Any health impacts on the mother (not related to economic or wellbeing impacts) were not described particularly fully in the readings I found, although there may be more research that I haven’t seen; I suspect they would be hard to entangle from the health problems which may have contributed to, rather than caused, a stillbirth.
If I was smarter, I’d have a better impression on where I fell on this issue. What I hope to point out in the article is that taking either position to an extreme results in a position that clashes with my, and I suspect many people’s, moral intuition. Probably further thought on this is required by people who have more experience with time discounting/health economics/actuarial sciences than me.
Presumably, some people do think this. I think for me to have a strong position on it I’d have to have strong positions on other, more fundamental moral questions that I haven’t come to good answers for.
You’re right; surely abortion, miscarriage, and stillbirth are all equally bad for the embryo/fetus/child and should either be counted as 0 or −70 depending on whether you count these as people or not. (Unless there’s some kind of Shapley value argument where an abortion of a 5-week embryo counts as only a fractional loss of life because it might have miscarried anyway even if there had not been an abortion, but I don’t think anyone is proposing such an accounting here.)
It’s frustrating that people downvoted you to −6 agreement but no one bothered to explain what they disagreed with.
Is it your first article like that? And did you write it solo? I’m not into global health, but overall it looks super impressive.
Hi, Liv- yes, it’s pretty much my first time doing something like this. I do have some medical background but I haven’t got any experience in policy/evaluation/whatever this is.
Fortunately, I had some great help and direction from the Cause Innovation Bootcamp organisers (especially my mentor Leonie), who put together some great materials on how to approach writing like this. It’s not where I’d like it to be in terms of completeness but I think we all reached a point where the return on further time invested didn’t make much sense.
Thankyou so much for your kind words- it’s surprisingly nerve-wracking posting something on the Forum like this, especially for a first-timer.
Hi—thanks for writing this—agree this is a somewhat neglected topic in general. You might want to look at a couple of my papers: a conceptual one (with my father and some perinatologists), and a follow-up empirical one that does actually ask people to try to put numbers on some of these important tradeoffs.
There seems to be an obvious route of inquiry to address this quandary, which is to ask what impact a stillbirth has on the number of children a woman has during her life. I imagine some nontrivial fraction of women who have stillbirths go on to become pregnant again in relatively short order, and end up having just as many children as they would have had the pregnancy succeeded. If, hypothetically, 90% of women who have stillbirths go on to have just as many children as they would have without the stillbirth, and 10% have one fewer children, then it seems straightforward to me that we should count a stillbirth as costing 0.1 lives. I don’t know actual numbers about how stillbirths impact women’s later reproductive choices, but presumably somebody has studied this.
Thank you for writing this exploration of such an important topic. EAs are too often unwilling to follow through on the moral implications of “the sanctity and preciousness of human life” even in the womb.