Explore our cost-effectiveness analysis of NEPI's innovative programme combining cash transfers and CBT to reduce crime in Liberia. With strong RCT evidence showing significant benefits to both recipients and the wider community, we estimate 22 WELLBYs per $1,000 donated. Read the report to learn how this promising intervention improves wellbeing and reduces criminality over the long term.
Joel McGuire
The experiences we have as young children are widely recognized as having lasting impacts in later life. Supporting parents to engage with their children shows clear short-term developmental benefits and may have profound long-term effects on wellbeing, as well as health and achievement later in life.
This report evaluates icddr,b's Reach Up parenting programme. Download and read the report to explore the Happier Lives Institute’s cost-effectiveness analysis, measuring the programme’s impact on long-term wellbeing in WELLBYs.
There can be toxic levels of lead in all sorts of surprising products, including cosmetics. Lead exposure causes a global health burden comparable to malaria and HIV but receives less than 0.1% of their funding - even though malaria and HIV are themselves neglected diseases. Reducing lead exposure also seems feasible, given the strong historical success of advocacy campaigns. We evaluate Pure Earth’s program to reduce lead in cosmetics in Ghana, involving two years of advocacy and data collection followed by three years of enforcement support for a lead ban. We estimate it delivers 108 WELLBYs per $1,000 donated ($9.23 per WELLBY), making it the most cost-effective charity we have reviewed to-date. Optimistic assumptions increase this as high as 1,359 WELLBYs per $1,000 ($0.74 per WELLBY).
Mental health disorders like depression and anxiety are common and significantly impact wellbeing, yet mental healthcare remains underfunded in low-income countries. Psychotherapy is an effective treatment that can be delivered cheaply by lay counsellors. This in-depth report evaluates the cost-effectiveness of two charities providing such therapy in Africa: Friendship Bench and StrongMinds. We estimate that Friendship Bench has a cost-effectiveness of 49 WELLBYs per $1,000 donated ($21 per WELLBY), and StrongMinds has a cost-effectiveness of 40 WELLBYs per $1,000 ($25 per WELLBY). Our results show that both charities are 5-6 times more cost-effective than cash transfers at improving subjective wellbeing. This is the fourth iteration of our analysis, which includes new data and refined methods. Our results are similar to the last version of the report, and we conclude that these two organisations are the most cost-effective charities (which are also well-evidenced) we have evaluated to date.
Globally, 45 million children suffer from malnutrition, leading to 2.3 million child deaths
annually. But even for those who live, the experience of malnutrition can have lifelong impacts on physical and cognitive health and social-emotional development. There is a consensus on how best to address extreme malnutrition: feeding kids a standard
formula of peanut butter enhanced with vitamins and nutrients alongside basic medical care to prevent or treat infections. This intervention, known as community management of acute malnutrition (CMAM), saves lives and improves health and development. What this report seeks to find out is how effective it is at also improving happiness.
Iron deficiency may be a major contributing factor to mental illnesses such as depression. In this shallow exploration, we evaluate the cost-effectiveness of Fortify Health's work to address mass scale iron-deficiency anemia in India.​ Read the report to discover what effect adding a small amount of iron to wheat flour may have on happiness.
This page is under construction and will be updated soon.
In November 2023, we published Version 3 of our psychotherapy analysis. This was a working report in which we estimated the effects of psychotherapy in low- and middle-income countries, as well as the cost-effectiveness of two psychotherapy charities: StrongMinds and Friendship Bench. In the first part of 2024, we have updated several parts of the analysis. This present, interim report, Version 3.5, describes the changes we have made so far. Our analysis suggests that both StrongMinds and Friendship Bench are among the most cost-effective charities we have evaluated to date. Friendship Bench has a cost-effectiveness of 53 WELLBYs per $1,000 donated and StrongMinds has a cost-effectiveness of 47 WELLBYs per $1,000 donated.
In this substantial update to our work on psychotherapy we conduct a systematic review, a meta-analysis, and cost-effectiveness analyses of two charities who deliver psychotherapy (StrongMinds and Friendship Bench). This is a working report that will be updated over time, results may change.
In this shallow cause exploration, we explore the impact of lead exposure on subjective wellbeing. We review the literature, model the impact of lead exposure on wellbeing, and conduct some back-of-the-envelope calculations of the cost-effectiveness of various interventions to decrease lead exposure.
In this shallow cause exploration, we explore the impact of immigration on subjective wellbeing. We review the literature, model the impact of immigration on wellbeing, and conduct some back-of-the-envelope calculations of the cost-effectiveness of various interventions to increase immigration.
In this shallow cause exploration, we explore the relationship between pain and subjective wellbeing; assess the severity and scale of chronic pain in terms of life satisfaction; and offer some novel back-of-the-envelope calculations for the cost-effectiveness of several interventions to treat pain.
In this report, we summarise the debate about the efficacy of deworming, present the first analysis of deworming in terms of subjective wellbeing, and compare the cost-effectiveness of deworming to StrongMinds (our current top recommended charity).
How should we compare the value of extending lives to improving lives? Doing so requires us to make various philosophical assumptions, either implicitly or explicitly. But these choices are rarely acknowledged or discussed by decision-makers, all of them are controversial, and they have significant implications for how resources should be distributed.
We raise twelve critiques of GiveWell’s cost-effectiveness analyses. Ten apply to specific inputs for malaria prevention, cash transfers, and deworming. Two are relevant for more than one intervention.
We propose the wellbeing-adjusted life year (WELLBY), the wellbeing equivalent of the DALY or QALY, as the obvious framework to do cost-effectiveness analyses of non-health, non-pecuniary benefits.
We make four recommendations to improve GiveWell’s cost-effectiveness analyses: (1) publicly explain and defend their assumptions about the effect of deworming over time; (2) explain their cost-effectiveness analyses in writing; (3) illustrate the sensitivity of their results to key parameters; (4) make it clear when an estimate is subjective or evidence-based.
We update our previous analysis to incorporate the household spillover effects for cash transfers and psychotherapy. We estimate that psychotherapy is 9 times (95% CI: 2, 100) more cost-effective than cash transfers. The charity StrongMinds is estimated to be 9 times (95% CI: 1, 90) more cost-effective than the charity GiveDirectly.
Drawing on evidence from over 80 studies and over 140,000 participants, we compare the cost-effectiveness of cash transfers and psychotherapy by estimating their effect on the recipient's subjective wellbeing and affective mental health.
This report explains how we determined the cost-effectiveness of StrongMinds using subjective wellbeing and affective mental health.
This report explains how we determined the cost-effectiveness of group or task-shifted psychotherapy in low- and middle-income countries using subjective wellbeing and affective mental health.
This report explains how we determined the cost-effectiveness of cash transfers using subjective wellbeing and affective mental health.
We set out our research priorities.
We know that cash transfers reduce poverty, improve health and enhance education but what impact do they have on how people feel and think about their lives? We find that cash transfers have a small, positive effect on subjective wellbeing, one that lasts for several years.
We show how Wellbeing-Adjusted Life Years (WELLBYs) can be used to estimate the value of different outcomes. We then estimate the values of two key inputs in GiveWell’s analysis: doubling consumption for one person for one year and averting the death of a child under 5 years old.