NEPI – Comprehensive Summary

Last updated: December, 2024

Problem

About 1 in 2 Liberians report being victimised by theft in the past year. But crime doesn’t just affect its direct victims; it impacts entire communities, affecting mental health, economic stability, and social cohesion.

Intervention

The intervention, called Sustainable Transformation of Youth in Liberia (STYL), is a combination of cognitive behavioural therapy and cash transfers delivered to high risk young men in Liberia. The therapy is an intense course (8 weeks, 4 hour sessions, three times a week)  of group CBT that attempts to improve self regulation, and encourage participants to identify as a regular member of society. The cash buys participants the time to practise and implement the lessons they learned in therapy.

Organisation

NEPI (Network for Empowerment & Progressive Initiative) is an organisation based in Libera that is scaling the use of STYL – CBT combined with a small ($300), one time, unconditional cash transfer – to reduce criminal behaviour.

Evaluation

Methods

The analysis evaluates the cost-effectiveness of NEPI’s combined therapy and cash programme to reduce crime by estimating its total effect on wellbeing.

This estimate incorporates two components. The first focuses on the direct benefits of NEPI to high-risk young men and their families. This measure is based on data from two studies of a randomised controlled trial of STYL (Blattman et al., 2017), including a 10-year follow-up (Blattman et al., 2023). Household spillovers are estimated using results from our psychotherapy analysis (McGuire et al., 2024b).

The second component estimates the broader societal gains resulting from reduced exposure to theft in the community. This measure relies on a correlational study that investigated the relationship between theft victimisation and life satisfaction across 20 African countries (n = 17,960).

Adjustments were applied to both components to account for concerns about replicability, reverse causality, self-report bias, and generalisability.

Impact

The programme’s total estimated benefit is 14 WELLBYs, primarily driven by speculative yet promising community-level effects (11 WELLBYs) and more robust individual-level impacts (3 WELLBYs).

Cost

NEPI estimates the current costs were around $630 per person treated. However, better cost data is currently being collected.

Cost-effectiveness

We estimate that the cost-effectiveness of NEPI is $45 per WELLBY. This means that for every $1,000 donated, the organisation creates 22 WELLBYs.

However, we think this analysis leans to the conservative side. The cost-effectiveness could be as high as 104 WELLBYs created per $1,000 donate if we take a few alternative analytical choices that we find reasonable but more uncertain and thus harder to defend (e.g., wider spillovers).

Quality of evidence

Our quality of evidence assessment is stringent. We assess quality of evidence according to an adapted version of the ‘GRADE’ criteria, a widely-used and rigorous tool for assessing evidence quality across healthcare and research fields. The GRADE criteria for evidence quality are very stringent, so we expect very few interventions that we evaluate for wellbeing in LMICs (which tend to be less well-studied) will score more than ‘moderate’ on the quality of their evidence. Considering most decisions about charities are made with little-to-no evidence, this is a substantial improvement.

We characterise the evidence quality as low, and thus the analysis that’s based on it as speculative. This is particularly due to the high degree of indirectness. The RCT evidence we use is extremely direct but the evidence we use to estimate the wellbeing effects (which represent most of the total effects) are quite indirect and low reliability. This is because they’re about the correlational evidence of burglaries (which may or may not reflect the typical wellbeing badness of crimes NEPI participants would commit).

Depth of our analysis

We also rate the depth of work gone into creating this estimate as very low. By this we mean that we believe we have only reviewed some of the relevant available evidence on the topic, and we have completed only some (30-70%) of the analyses we think are useful. We have spent about 80 hours on this analysis.

Funding need

 We believe the funding gap will be $613,000 in 2025.

Conclusion

We think NEPI has promising cost-effectiveness, and we are excited about this intervention’s potential to address a very hard problem to solve: crime. We think it’s plausible that NEPI’s cost-effectiveness could be higher, up to 104 WBp1k, largely based on the plausibility of higher spillover effects within the household or recipients (who commit less crime), their would-be victims, and the wider community.

We characterise the evidence quality as weak, the analysis as speculative and recognize these estimates could move around substantially with more evidence or research time. Relatedly, we think further would be extremely valuable (if difficult) to acquire more evidence of the causal effects on the wellbeing benefits of averting crime in general, and by NEPI style programmes in particular.

Our reports so far

We have one shallow report on NEPI so far.