When a child is born, a clock starts ticking. Scientists have shown that half of a child’s intelligence potential is developed by the age of four. Early development makes a huge difference to life-long wellbeing.
It is little surprise that distinguished economists who studied responses to Haitian challenges have focused attention on powerful investments that target children in infancy and in the womb.
Haïti Priorise is a research project funded by the Government of Canada that has worked with more than 700 sector experts representing government, donors, think-tanks, universities and NGOs, and with 50 economists from Haïti and abroad to identify and study 85 proposals to improve Haiti’s social, economic and environmental wellbeing.
The eminent panel – advisor to the Executive Directors of Haiti at the World Bank Group and the International Monetary Fund Ketleen Florestal, former governor of the Central Bank Philome Joseph Raymond Magloire, renowned Haitian economist and economics commentator Kesner Pharel, and Nobel laureate economist Vernon Smith – considered the new economics research and interviewed all of the authors in Port-au-Prince last may.
After deliberation, the distinguished economists issued a list of priorities, which they presented to President Jovenel Moïse, Prime Minister Jack Guy Lafontant, President of the Senate Youri Latortue, and other Cabinet members. Additionally, they presented the research to the Minister of Planning and External Cooperation, Aviol Fleurant, and MPCE technicians.
Among the top-ten research proposals – along with compelling ideas to build economic prosperity by reforming Haiti’s electric utility, improving the Cap-Haitien port, and expanding mobile broadband access, and to reduce trauma deaths by training first responders – are six proposals that would make a big difference while the clock is ticking on a child’s earliest development.
The panel heard new research by World Health Organization economist Karin Stenberg and co-authors showing that improving access to emergency obstetric care to manage complications around birth would avert 505 maternal deaths per year. Nearly 4,000 more newborns would survive each year, and 859 stillbirths would be prevented. Every gourde spent on this would generate benefits to society worth 16 gourdes.
Once a child is born, it is crucial to provide protection against illness. Ministry of Planning and External Cooperation (MPCE) economist Magdine Flore Rozier Baldé presented evidence on the benefits of lifting infant immunization coverage to 90% by 2020, and found that doing so would cost 2.4 billion gourdes over five years, immunize 864,000 additional children, and save more than 16,000 lives. Benefits are worth 32.3 billion gourdes, making it a phenomenal investment.
Increasing family planning access is another proposal the Eminent Panel declared one of the top priorities for Haiti. Doing so would cost 1,496 Gourdes per woman, or 1,543 million Gourdes annually to reach all of the women in Haiti who need this, according to Professor Hans-Peter Kohler of the University of Pennsylvania. He found that family planning programs have a myriad of benefits: they reduce maternal and child mortality, improve child health, female education, women’s general health, female labor-force participation and earnings. In Haiti, the under-five mortality rate could be cut by as much as 70% through improved family planning access. Having fewer children means relatively more people of working age, making Haiti slightly more productive. Taking this into account, every gourde spent on expanding sexual reproductive health services would generate benefits worth 18 gourdes.
Early in a child’s life, access to educational stimulation can create the conditions for success as an adult. Education economist Atonu Rabbani presented evidence to the eminent panel showing that two years of teacher-led play sessions that help with things like socialization would cost around 5,500 gourdes ($79) per student per year. A famous, long-term research experiment in Jamaica gives good reason to believe that such a policy will lead to an increase of 35 percent in future earnings. Based on the compelling return on investment – 14 gourdes for every gourde spent – the eminent panel found that this should be a priority for Haiti. Kesner Pharel concluded that, “Early childhood education can instill a love of learning that lasts a child’s entire life.”
Finally, the panel found that improving nutrition is one of the most powerful investments that can be made in a young child’s life. The distinguished economists considered research by Stephen Vosti of the University of California, Davis, and colleagues, on the merits of adding iron and folic acid to wheat flour when it is milled or bagged in Haiti. This is called “fortification”, and can be adapted to add vital micronutrients to any staple food product.
Although this would improve folic acid and iron intake for everyone, it would have the biggest impacts for pregnant women and young children. Spending 331 million gourdes to fortify 95% of wheat flour will stop 140 neural tube defect deaths and more than 250,000 cases of anemia annually. This is relatively cheap, and has huge and lasting impacts worth 7.9 billion gourdes in financial terms. Raymond Magloire pointed out, “Wheat flour fortification is a very cheap intervention, involving cooperation between the government and Haitian industry to ensure that micronutrients are added at the mill. I find that there is a compelling case that fortifying a staple food product could make a significant difference to an important nutritional problem.” Similarly, Ketleen Florestal concluded that the proposal has “transformative” potential: “if carried out correctly in the Haitian context, this could improve the diets and health of many people and remove a significant disadvantage from a significant portion of the population.”
The eminent panel’s findings on nutritional, health and educational interventions show that there would be huge benefits from Haiti investing in these top interventions that focus on a child’s earliest and most crucial years.