Hi Nick! Thanks so much for your thoughtful feedback. My colleagues have answered, but I would like to respond to your comments on kangaroo care, ORS and zinc!
On Kangaroo care
1. Thanks for your note on generalist talent—we will note this down. 2. I agree with you! This intervention includes large behavior change activities (not only from caregivers but also practitioners) - KC can tend to be seen as a “second rate” solution to lack of resources, as well, instead of the proper medical care it is. 4. We will note this down for our future co-founders!
On ORS
On trials and targeting. Yes, I fully agree—this intervention must be well targeted to find places where it would be additional; this is something we focus on more in the full report! On NGO speak. Noted—in the full report, we discuss some evidence of plausible intervention models that are a bit more pinned down - having said that, I generally agree that getting the ORS to those that need it is a better option. Other models would be additional (and up to debate).
Dear Seth,
Thank you for your support and thoughtful comments! Apologies for the delay – it’s a really busy time for us.
To clarify, we aimed for 5x GiveWell bar for health policy ideas—the text is an example of our goals in our research process. For this round, the bar needed to be more formally established.
Our claim for the idea around IPV is that the modeled cost-effectiveness for a “hypothetical 5-year intervention in Lesotho, Rwanda, Angola, and Ethiopia revealed a cost per disability-adjusted life year (DALY) averted ranging from $28 to $1419”. The wide range is because it is highly unclear how one should model the DALY burden of IPV, among other reasons. Our full report is published on our website now, so you can further dig into our thinking behind this. Of note, GiveWell tends to use a cost-effectiveness bar of $100-150 per DALY averted (which they claim to be ~8X GiveDirectly, note this is no longer the case given OP updates), which means that our estimates for this charity fall within the range of 40-0.5x GiveDirectly in cost-effectiveness. However, we aren’t sure if GiveWell has directly included these IPV benefits in its evaluation of GiveDirectly’s program.
Regardless, thanks for bringing this Haushofer et al. (2019) paper to our attention, We hadn’t seen this paper during our research, which is a pity. I cannot look into the paper in detail now; hopefully, my above clarification shows that we aren’t directly claiming a “ 50x over GD” bar. What you say sounds roughly true—I’d expect cash transfers to be far more expensive per person (mass media would be cents per person reached) but more effective (if the effect holds—I haven’t looked at the paper in any detail).
On your second point. We write a bit more about our sense of what the mechanism behind the intervention is in the report. To summarise—there is no clear sense in the literature about the main accepted mechanism for reducing violence or the true causal link between attitudes/norms and the prevalence of violence. It’s plausible that finances are a part of this, but it is likewise plausible that patriarchal norms, acceptability, etc., play a role. Different papers point in different directions, and this is an area that would benefit a lot from further research so that we can understand what works best. The context will matter a lot as well in terms of what drives violence and what type of violence is committed.