Save a life or give cash: Which do people prefer?

Every year more than $150 billion in aid is spent on international programs, and far more is spent by governments themselves. Whether this money goes toward saving a child’s life or giving cash to a farmer is at the discretion of the decision- maker, usually not accounting for what the community itself prefers or values. Prior to this report, little evidence or data existed on capturing preferences and values of people in low-income settings. To fill the gap, international organizations and governments often use their own discretion to decide whether families should receive cash transfers or malaria nets. This report provides a potential way forward to ensure programs and funding allocations are accountable to the people impacted by them.

In 2018, IDinsight, a data analytics, research, and advisory organization, worked with GiveWell, a nonprofit that finds and recommends high-impact giving opportunities, to help it better incorporate the preferences of people and communities into its charity recommendations. GiveWell recognized that every philanthropic organization, including itself, faces complex moral trade-offs. For example, GiveWell’s charity ranking list requires it to weigh the importance of saving a life versus improving a family’s income. To make these trade-offs, prior to this research, its staff considered conventional assumptions used by other policymakers, relevant research from high- or middle-income countries, and its own models based on life expectancy at different ages, harms associated with grief, and other factors.

“We’re excited to share this research. How the people and communities we serve value different good outcomes is an important input into decisions about how to allocate funding among programs. Our collaboration with IDinsight is a first step and we hope others will help grow the body of research around these questions.” – Elie Hassenfeld, co-founder and Executive Director of GiveWell

“Hundreds of billions are spent every year trying to improve lives. But how that money is spent is rarely informed by the preferences of the people impacted by it. I believe IDinsight’s new community preferences work and collaboration with Givewell potentially has significant implications for national governments as well as the international development community.

We need to better measure and amplify the preferences of low-income communities in large scale decision-making. There is also a moral case for using evidence to inform decision-making: if used effectively it can elevate the voice of the people impacted by anti-poverty programs. We look forward to working with others to deepen this research through additional exploration and partnerships.” – Neil Buddy Shah, co-founder and CEO of IDinsight

Among other notable results, IDinsight found that survey respondents place a higher value on saving lives relative to increasing consumption than predicted by extrapolations from similar data captured in high-income countries. In addition, survey respondents consistently value the lives of children under five higher than individuals over five. These new measurements will inform GiveWell’s upcoming top charity recommendations, which last year generated $140 million in funding for international programs.

IDinsight encourages additional exploration to further develop an understanding of people’s preferences across program areas and different populations.