Abstract
We conduct a benefit-cost analysis of a package of early childhood interventions that can improve nutrition outcomes in Haiti. Using the Lives Saved Tool, we expect that this package can prevent approximately 55,000 cases of child stunting, 7,600 low-weight births and 28,000 cases of maternal anemia annually, if coverage reaches 90% of the target population. In addition, we expect these nutrition improvements will avoid 1,830 under-five deaths, 80 maternal deaths and 900,000 episodes of child illness every year. Those who avoid stunting will experience lifetime productivity benefits equivalent to five times gross national income per capita in present value terms, at a 5% discount rate. While previous benefit-cost analyses of this specific package have only estimated the lifetime productivity benefits of avoided stunting, this paper also accounts for reductions in fatal and non-fatal health risks. In the base case scenario, the annualized net benefits of the intervention equal Haitian gourdes 13.4 billion (USD 211 million) and the benefit-cost ratio (BCR) is 5.2. Despite these substantial benefits, the package may not be the most efficient use of a marginal dollar, with alternative interventions to improve human capital yielding BCRs approximately three to four times higher than the base estimate.
Highlights
Haiti has the poorest health and education outcomes in the Western Hemisphere
We find health impacts represent 13–58% of the total benefits depending on the discount rate applied, so their inclusion is material
In the base case scenario, our results indicate that the provision of this package is an effective use of development money, with annualized net benefits of Haitian gourdes (HTG) 13.4 billion or USD 211 million per year5 and a benefit-cost ratio (BCR) of 5.2
Summary
Haiti has the poorest health and education outcomes in the Western Hemisphere. Its infant mortality rate (51 deaths per 1000 live births in 2016) is three times higher than the Latin America and Caribbean average, while the maternal mortality rate (359 per 100,000 live births) is five times higher than the regional benchmark (World Bank, 2017). Benefit-cost analysis is a useful tool to determine effective uses of Haiti’s limited funds It is against this backdrop that this paper undertakes a benefit-cost analysis of an intervention that addresses both health and education related challenges in Haiti, and has the potential to be highly effective: the provision of a package of early childhood interventions to address nutritionrelated outcomes such as stunting, wasting and low birthweight. This paper uses the Lives Saved Tool commonly shortened to LiST (see https://www.livessavedtool.org/ for further details) to model both the nutrition and health effects of scaling up this package of interventions to cover 90% of pregnant women and 0–2-year-old children in Haiti This intervention is expected to prevent approximately 55,000 cases of child stunting, 7,600 babies being born with low birthweight and 28,000 cases of maternal anemia. The net benefits range from HTG 4.6 billion to HTG 18.6 billion (USD 73 million to USD 294 million) due to variation in the estimates on the impact of stunting on lifetime productivity
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