CEA for funding early-life growth interventions in low-income countries (looks only at adult economic impacts)

This does not include other potential benefits of birth weight interventions, such as lower levels of adult noncommunicable disease and disability. These effects have been supported by research but I haven't vetted it yet.

Uncertain. I was unable to quickly find cost estimates for maternal nutrition supplementation so I used the estimate for postnatal complementary feeding via food provision from Horton et al. 2010 ($60 per year, p. 23, https://documents.worldbank.org/en/publication/documents-reports/documentdetail/655431468163481083/scaling-up-nutrition-what-will-it-cost). I then prorated it to 9 months, yielding an estimate of $45. There is some evidence that prenatal iron supp can increase birth weight but I haven't looked into it much beyond noting that a couple of meta-analyses don't show much of an effect. It's possible that it would be more cost-effective despite smaller effects. I didn't use an estimate for diet counseling here because Gresham et al. meta suggests it's not effective (https://doi.org/10.3945/ajcn.113.080655).

Somewhat uncertain. Per-child cost of complementary feeding education according to Horton et al. 2010 p. 76 (https://documents.worldbank.org/en/publication/documents-reports/documentdetail/655431468163481083/scaling-up-nutrition-what-will-it-cost).

From 2020 CEA https://docs.google.com/spreadsheets/d/1BmFwVYeGMkpys6hG0tnfHyq__ZFZf-bmXYLSHODGpLY/edit#gid=1680005064&range=B42

See "consumption" tab

Estimated life expectancy at birth in high-stunting countries (see "life expectancy" tab).

Assumes earnings begin at 16 years and a midpoint intervention age of -4.5 months (halfway through pregnancy)

Assumes earnings begin at 16 years and a midpoint intervention age of 1 year

Moral weight assumption; late 2020 moral weights (not currently public)

Moral weight assumption; late 2020 moral weights (not currently public)

From the 2020 CEA https://docs.google.com/spreadsheets/d/1BmFwVYeGMkpys6hG0tnfHyq__ZFZf-bmXYLSHODGpLY/edit#gid=2064365103&range=B3

This is an uncertain guess but it seems likely that the impact of growth is larger in lower-resource settings where parents don't necessarily have the resources to devote extra to smaller children to catch them up. See our report "The impact of early life growth on adult economic status" for a discussion of this.

This is an uncertain guess but it seems likely that the impact of growth is larger in lower-resource settings where parents don't necessarily have the resources to devote extra to smaller children to catch them up. See our report "The impact of early life growth on adult economic status" for a discussion of this.

The literature is fairly convincing overall but it has limitations that inspire some skepticism, especially the RCT literature. Adjusting to 0.8 based on possible publication bias that could inflate effect sizes.

I have a lot of uncertainty about my 0-2 year estimate but effect size exaggeration should be the same as birth weight since the former is derived from the latter.

From 2020 CEA; this is a standard adjustment we use to reflect the fact that income earned by one person will benefit others in a household. https://docs.google.com/spreadsheets/d/1BmFwVYeGMkpys6hG0tnfHyq__ZFZf-bmXYLSHODGpLY/edit#gid=1364064522&range=B122

From Gresham et al. 2014 meta-analysis of birth weight effects of maternal diet interventions (http://ajcn.nutrition.org/content/100/5/1298.long). Used estimate from underweight and nutritionally at-risk pregnant women. See Table 4, Birth weight, BMI, underweight/nutritional risk (Pg 1318). Food provision was fairly effective but dietary counseling was not.

From Lassi et al. 2013, Pg 5 meta-analysis of early life (6-24 mo) growth effects of education or providing complementary foods (https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-13-S3-S13). Represents interventions in food-insecure countries.

Somewhat uncertain. To calculate this, I used my effect size estimate from "The impact of early life growth on adult economic status" and converted it into a z-score by dividing it by the standard deviation of the samples it is based on (simple mean of the SDs of the two studies it is based on that reported SDs: Behrman and Rosenzweig 2004 and Black 2005). Mean SD is 19.75 oz (Pg 63), effect size estimate is 3.7% per lb (Pg 62).

Highly uncertain. I was unable to estimate the effect size of this effectively because there isn't an informative evidence base on it (see our report The impact of early life growth on adult economic status."). I assumed an effect size of 2/3 the birth weight effect per z-score. This is based on the general principle (from the animal research literature, discussed in our report) that the earlier the growth restriction occurs, the more impactful it is.

Units of value per dollar donated, consumption gains, validity/replicability adjustments applied (birth weight intervention)