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Benefit-Cost Analysis of a Package of Early Childhood Interventions to Improve Nutrition in Haiti

  • Brad Wong (a1) and Mark Radin (a2)

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.

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This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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We would like to thank three anonymous referees, Scott Grosse, Jim Hammitt, John Hoddinott, Lynn Karoly, Bjorn Larsen, Carol Levin, Peter Orazem, Roger Perman, Lisa Robinson and Dale Whittington as well as participants at Guidelines for Benefit-Cost Analysis project Methods and Case Studies Workshop, November 2017 at Harvard University, for insightful comments on earlier drafts of this paper. We are also grateful to Victoria Chou and Adrienne Clermont for helpful guidance on LiST and to Steve Vosti and Reina Engle-Stone for help in understanding the coverage of nutrition interventions in Haiti. The lead author is indebted to Bjorn Lomborg for many conversations over the years, which have significantly sharpened his understanding of the craft of benefit-cost analysis. This work was supported by the Bill & Melinda Gates Foundation [OPP1160057]. The views expressed in this paper are those of the authors and do not necessarily reflect the views of the Gates Foundation or the Copenhagen Consensus Center.

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