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Will Givewell recommend breastfeeding promotion before 2027 [forecast] [crosspost]
3 min readNov 9, 2021
20
This is crossposted from Metaculus (I wrote the original question). If you'd like to forecast it, go here:
GiveWell has recommended grants to over 10 charities over the years. They are currently investigating 14 charity areas including breastfeeding promotion.
The following sections are quoted from GiveWell’s explanation of the topic:
“The World Health Organization (WHO) and UNICEF recommend early initiation of breastfeeding, exclusive breastfeeding to 6 months, and partial breastfeeding to age 24 months to improve infant and maternal health, but the majority of infants are not fed according to these guidelines. Mothers may not breastfeed as long or as intensively as they would like due to a lack of skills and support, so various maternal counselling and support interventions promote breastfeeding behaviour change.”
Effectiveness for the following reasons: “We believe there is reasonably strong evidence that breastfeeding support programs can lead to increases in rates of exclusive breastfeeding up to 6 months (compared to some or predominant breastfeeding) and breastfeeding duration, as recommended by WHO/UNICEF. Their impacts on exclusive breastfeeding may be larger in low-income countries. There is additional evidence that increasing breastfeeding reduces diarrhoea morbidity, which likely leads to reductions in childhood mortality from diarrhoea. It may also cause additional benefits that we have not yet vetted.”
This question resolves positively if GiveWell publishes a recommendation that grants be given to support breastfeeding promotion or on or before December 31, 2026. Or if a breastfeeding promotion charity is designated a top charity before December 31, 2026.
This may happen in the following ways:
If GiveWell publishes a recommendation that is no longer in force in 2027, this question resolves positively. Eg GiveWell no longer recommends grants to GiveDirectly, but it once did.
If GiveWell revokes a recommendation due to making errors in its calculations, this question will resolve ambiguously.
The category “standout charities” used to exist. It no longer does, so can be ignored.
If the GiveWell program reviews spreadsheet is no longer linked from this page, a superseding spreadsheet may be used. A superseding spreadsheet should have very similar column headings or the same title (“GiveWell programme reviews) or be linked under “prioritized list of programmes” from this page or failing that, be the consensus choice of admins commenting on the question.
For clarity, if the above criteria aren’t met, but a reasonable spreadsheet exists which contains a grant for breastfeeding promotion exists, admins can post their suggestions of the spreadsheet in the comments of this question. Admins can change their votes, but at the time of resolution, all admins should have commented in favour of the same spreadsheet. If they have not, and the question does not resolve positively by any of the other methods, the question resolves ambiguously.
Hi, everyone! I think the question here is focused on the higher order questions of what GiveWell will recommend (and one level higher) how to ask forecasting questions about it. But, to not answer that, I will say that at r.i.c.e., our fieldwork in India is, in the sense of a majority of our time, effort and staff, mostly spent on lactation consulting and Kangaroo Mother Care for low birthweight babies right now. (One question for the author might be whether a KMC program, which is fundamentally about breastfeeding but also has other mechanisms (keeping the baby warm, keeping the caregiver informed about the baby's status) would could as breastfeeding promotion for this forecast.)
We're working in Uttar Pradesh, which is a context where women's modesty is an important cultural issue. But one challenge we are facing is demand: it's hard for us to get mothers and families more broadly to want to go along with our program. I don't think this should have surprised us so much, but in fact the bindingness of this constraint did surprise us. I would be very excited to hear about practical research, ethnography, or just trial and error anyone is doing about this.
From a prioritization point of view, this sort of approach competes against more resource-intensive neonatal care, such as investing in incubators (which may or may not be plugged in and turned on) which work against establishing breastfeeding by separating the moms and babies. So, another indirect way of doing "breastfeeding promotion" may be to lean against that sort of medicalized policy.
Like so many things for early-life health in poor populations (open defecation, clean cooking fuel use,...), this is an area where the "second stage" biological mechanism seems very well established to me, and what we need is good evidence and strategies for a better "first stage" effect of programs on behavior change.
Thanks Dean, love to hear from an expert.