Works at Fortify Health (GiveWell-supported non-profit), focused on reducing iron-deficiency anaemia in India through wheat flour fortification. Former Research Associate at IMI Kolkata. Don Lavoie Fellow, Mercatus Center (AY 2023-24). Interests: EA in global health and development, impactful philanthropy, and evidence-driven poverty alleviation in LMICs.
SK Saiful
Karma: 20
Hi Arepo, thanks so much for reading and for this question—it’s a fair one and I want to be honest about where that estimate comes from.
The short answer is that the 3-5x figure is genuinely illustrative at this stage—it’s not derived from a formal model. It’s a rough directional inference drawn from two places: the J-PAL and Cochrane evidence on community health worker programmes and maternal micronutrient supplementation in comparable South Asian delivery contexts, and the documented cost and output limitations of mobile medical van deployments in factory catchment areas in India.
When you stack those against each other informally—cost per patient contact, adherence rates, impact on underlying disease burden—the gap feels large. But I haven’t yet done the work to put proper confidence intervals around it or model it formally against Indian cost structures. That’s exactly what the working paper is meant to do.
So “plausible” was probably doing too much work in that sentence. What I meant was: directionally I believe the gap is real and significant, but I wouldn’t want anyone to cite the 3-5x figure as if it’s a measured estimate right now. It’s more of a prior that needs testing.
Really appreciate you pushing on this—it’s one of the places where the post was deliberately honest about its limits but could have been clearer about what “illustrative” actually means in practice.