EA - Family Empowerment Media: track record, cost-effectiveness, and main uncertainties by Rethink Priorities

Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Family Empowerment Media: track record, cost-effectiveness, and main uncertainties, published by Rethink Priorities on June 12, 2023 on The Effective Altruism Forum.Editorial note and disclaimerThis report assesses the nonprofit Family Empowerment Media (FEM). The project was commissioned and supported by a donor who wishes to remain anonymous. It was conducted in February 2023 over two weeks.This report attempts to estimate the cost-effectiveness of FEM, mainly relying on two existing cost-effectiveness analyses (from GiveWell and Founders Pledge). We were asked to look into the cost-effectiveness of the organization in an unbiased way, and we started the research without a prior for whether this organization would be cost-effective or not. In this report, we express cost-effectiveness as a function of the cost-effectiveness of cash transfers (like the original models mentioned above). We did not analyze the cost-effectiveness of any other family planning interventions, so we cannot and do not make any claims about how FEM compares to other family planning interventions.In addition to looking at the cost-effectiveness of FEM’s program, we describe their track record to date, and try to determine the main uncertainties about the program and its (cost-)effectiveness.We relied on four expert interviews to attempt to answer some of the questions: We interviewed Anna Christina Thorsheim (Executive Director and cofounder of FEM), Andrew Martin (Senior Research Analyst at GiveWell), Rosie Bettle (Applied Researcher at Founders Pledge), and Dr. Mukhtar Muhammad (medically trained expert in social and behavior change communication with a historical focus on family planning programming).We have tried to flag major sources of uncertainty in the report and are open to revising our views as more information becomes available.We would like to mention that Melanie Basnak previously worked at Charity Entrepreneurship (CE), the nonprofit organization that incubated FEM. Melanie did not overlap with Anna Christina Thorsheim during her time at CE and believes she oversaw this research in an unbiased manner.Executive summaryIn a randomized controlled trial in Burkina Faso from 2016-2018, a family planning mass media campaign led by the nonprofit Development Media International (DMI) led to a 5.9 percentage point (20%) increase in the modern contraceptive prevalence rate (mCPR), leading the study authors to estimate a cost effectiveness of $7.70 per couple-year protection, albeit with uncertainty. The nonprofit Family Empowerment Media (FEM) ran a pilot family planning mass media campaign in Kano, Nigeria, and they observed a 6 percentage point (75%) increase in mCPR using less rigorous pre- and post-pilot data comparisons. GiveWell conducted a cost-effectiveness analysis (CEA) of DMI’s intervention, finding it to be 1.1-5.4x the cost-effectiveness of cash transfers, depending on the context. FEM altered the model to pertain to its pilot intervention in Kano, finding that their intervention was ~27x the cost-effectiveness of cash transfers.Founders Pledge conducted a separate CEA, finding a cost-effectiveness of ~22x that of cash transfers, complete with a full (unpublished) report.We used the original models as a starting point to conduct our own cost-effectiveness estimation, tweaking certain values. In most cases, our adjustments would tend to increase these existing cost-effectiveness estimates, so we are confident that the cost-effectiveness of FEM’s intervention beats that of cash transfers, and we believe that their cost-effectiveness might be higher than GiveWell’s and Founders Pledge’s estimates. However, we would like to see several remaining uncertainties resolved before we would feel confident putting a bound on cost-effectiveness, and we discuss these uncertainti...