International development leaders frequently make complex resource allocation decisions that require weighing trade-offs between different types of good outcomes. For example, given limited resources, which should be prioritized: a program that increases household income or one that saves lives? When comparing diverse charities, GiveWell makes these decisions transparent by asking staff members to provide their ‘moral weights.’ These judgments are based on philosophical reasoning, intuition, and data on beneficiary lives, and extrapolation of preferences from studies of less relevant populations. Prior to this study, there was a clear lack of data on how potential beneficiaries of such interventions trade-off between different outcomes. This study represents a step to fill this gap for strategic international development decision-making.
An enumerator interviews a survey participant of the beneficiary preferences project supported by GiveWell.
We surveyed over 1,800 low-income individuals across four diverse regions in Ghana and Kenya. Three main methods1 were used to capture how respondents trade-off between averting deaths of individuals of different ages and increasing consumption:
We also collected qualitative data on beneficiaries’ reasoning when making these trade-offs, and data on beneficiaries’ lives that can be used to inform GiveWell staff’s moral weights.3
Qualitative data suggests these high valuations are driven by a large proportion of individuals making two arguments. The first argument asserts the importance of accounting for the potential held by all individuals to achieve high economic and social value over their life course. A second common argument is that life holds inherent value and therefore no amount of money is sufficient to forego the chance to save a life.
For GiveWell, incorporating the preferences captured in this study and described above would result in:
This would lead to higher relative cost-effectiveness of charities whose good is achieved primarily by averting the death of young children (e.g. Helen Keller International, Malaria Consortium, and Against Malaria Foundation, etc.).5
Beyond GiveWell, this study demonstrates that it is possible to inform the complex, moral trade-offs faced in development by capturing the preferences of the people affected by these decisions. It also represents a substantial addition to the existing literature on individual cross-outcome preferences, in which low-income populations and particularly those in Sub-Saharan Africa, have previously been severely underrepresented.
In a development sector that is generally reluctant to rigorously compare different types of outcomes, we believe this study could make the use of portfolio-level cost-effectiveness analysis more appealing. We encourage additional research to further develop an understanding of beneficiary preferences across program areas and from different populations.
7 November 2019
3 March 2020
2 December 2019
IDinsight and GiveWell completed a two-year effort to identify preferences of potential aid recipients to inform its giving.
23 June 2021
30 May 2020
30 May 2019
15 November 2021