Haïti Priorise Eminent Panel Findings
Port-au-Prince, May 3 2017
Like all nations, Haiti has limited resources and prioritization among potentially unlimited interventions is needed. Understanding the costs and benefits of different proposals can improve the public conversation about priorities. Haïti Priorise has worked with more than 700 sector experts representing the government, donors, think-tanks, universities and NGOs, and with 50 economists from Haïti and abroad to identify and study 85 concrete proposals that would improve the nation’s social, economic and environmental wellbeing. Forty-five research papers have been written and peer-reviewed by academics and sector experts. These research papers have each been presented to an Eminent Panel in Port-au-Prince.
Top 10 policies
1. Reform electricity utility
Improving the legal regulatory framework to create the conditions for an autonomous, accountable and efficient electric utility. It will substantially reduce the losses experienced by Electricité d’Haïti. This will cost 2.25 billion
gourdes. Benefits are worth 49.2 billion gourdes.
2. Wheat flour micronutrient fortification
Adding iron and folic acid to wheat flour during milling in Haiti. Spending 331 million gourdes to fortify 95% of wheat
flour will avert 140 neural tube defect deaths and more than 250,000 cases of anemia annually. Benefits are worth 7.9
3. Early childhood stimulation
Providing two years of teacher-led education before primary school for 516,000 children. This will cost 7 billion gourdes
annually. This will mean higher earnings for children when they grow up. Benefits are worth 115 billion gourdes.
4. Train first responders
Providing several days of first-aid training to volunteers across the country. This will cost 80m gourdes and save
around 700 lives every year.
5. Immunization for children 0-1
Amplifying infant immunization coverage to 90% by 2020. This will cost 2.4 billion gourdes over five years. Over five
years, 864,000 additional children will be immunized, and 16,000 lives saved. Benefits are worth 32.3 billion gourdes.
6. Maternal and newborn health
Providing healthcare for pregnant women and newborns. Reaching 95% coverage will cost 11 billion gourdes. This will
reduce the maternal mortality rate by 65%, saving the lives of more than 500 mothers and 3,000 newborns.
7. Access to contraception
Expanding sexual and reproductive health services to meet 100% of unmet need will cost 1,500 million gourdes annually,
cut under-5 mortality by 70%, reduce maternal mortality, and create a ‘demographic dividend’.
8. Skilled assistance at delivery
Ensuring skilled midwifes provide care at birth for normal deliveries, including neonatal resuscitation and clean
postnatal practices. This will avert 1,700 deaths each year.
9. Expand mobile broadband
Increasing mobile broadband penetration to fifty percent over 5 years and installing an undersea cable to support the
increased traffic will cost 56 billion gourdes. This will stimulate economic growth and reap benefits worth 685
10. Electronic port custom system
Computerization of procedures at the Port of Cap-Haitien to lower costs for port services, which will also increase
customs revenue and decrease smuggling. The benefits are worth more than 5 billion gourdes.
The Eminent Panel
The Eminent Panel comprises:
- Ketleen Florestal has worked since 2010 at the World Bank Group as an Advisor to the Executive Director for Haiti. She also represents Haiti at the International Monetary Fund’s Board of Executive Directors. Recently she occupied the function of LAC Borrower Representative in the IDA18 Negotiations. Previously, she served as a co-focal point for Haiti for the g7+ grouping of 20 countries in fragile situations. She has also worked as senior economist at the Interamerican Development Bank and in various functions and positions in Haiti at the Ministry of Economy and Finance, the Central Bank, the Ministry of Justice. She holds a BA in Economics from Princeton University, an MIA in Economic Policy Management from Columbia University and an MA in Applied Economics from John Hopkins University. She also studied law at the State University of Haiti.
- Philomé Joseph Raymond Magloire, former governor of the Central Bank (BRH), specializes in finance and economics. His early professional career was with the IDB. He has provided consulting services to business and government, and has been a member of various private sector organizations. He obtained a Bachelor’s degree in Business and an MBA from Columbia University (USA) and has taught at Quisqueya University in Haiti, the University of Puerto Rico, and the City University of New York.
- Dr. Kesner Pharel, a prominent economist playing a central role in the dissemination and sensitization of economic issues, especially matters concerning public finance, via his weekly commentary on RadioTele Metropole and innumerable speaking engagements. He began his career at the Central Bank and went on to found the consultancy firm, Group Croissance, in 1994, of which he is the chairman and CEO. Pharel works closely with public institutions, municipal administrations in particular on budgeting and development planning. Pharel attended George Washington University, obtaining Bachelors degrees in Economics and Political Science. He has a Masters in Public Administration from Harvard University, and a Masters in Sports Administration from the University of Lyon.
- Dr. Vernon L. Smith, who was awarded the Nobel Prize in Economic Sciences in 2002 for his groundbreaking work in experimental economics. Dr. Smith has joint appointments with the Argyros School of Business & Economics and the Fowler School of Law, and he is part of a team that will create and run the new Economic Science Institute at Chapman.
The Haïti Priorise research methodology
Haïti Priorise follows the Copenhagen Consensus approach, refined over thirteen years to improve global, regional and national spending priorities. It is undertaken with financial support from the Government of Canada.1
In 2016, extensive stakeholder meetings were held with nearly 150 individuals representing government and donors, academia, NGOs, think tanks, and sector experts. The Strategic Development Plan for Haiti (Plan stratégique de développement d'Haïti) and international stakeholder reports were analyzed, to identify key topics for analysis. These topics were reviewed by two Reference Groups, comprising key domestic stakeholders and high-level representatives from the international donor community. Sector expert roundtable meetings were held, covering 18 topic areas.
This process led to the identification of more than 1,000 responses to national challenges. More than 700 representatives from the government and donors, think tanks, NGOs, universities and sector experts were invited to assess the best topics for cost-benefit research. With additional inputs from the Reference Group, a final short-list of interventions was identified for research.
Research papers were commissioned from local and international specialist economists, to analyze the costs and benefits of more than 80 specific proposals. Assumptions were standardized to allow for comparison between different proposals. Peer review was embedded into the research process, to ensure quality while capturing a broad range of expert perspectives. In addition, sector experts from Haïti provided reviews.
The Haïti Priorise project was guided by an Advisory Council that comprises:
- Camille Chalmers is a professor at the State University of Haiti since 1980, his courses include social planning and project management, where cost-benefit analysis is a component. He is the coordinator of PAPDA (Plateforme haïtienne de Plaidoyer pour un Développement Alternatif), a civil society platform which includes organizations from a variety of sectors. The platform exists to engage with government on political and developmental alternatives. He is also a member of two research groups within CLACSO (Concejo Latinoamericano de Ciencias Sociales), which work on identifying the principles obstacles to social and economic development.
- Dr. Eddy Labossiere has a BA in civil engineering from the State University of Haiti, an MBA from the Université de Montreal HEC in Canada, an MA in economics from Florida International University and a PhD in Economics from the City University of New York (CUNY). After having worked in the Ministry of Planning for 15 years, he provides consultancy services to Parliament, the Central Bank, and the Ministry of Finance. He is also a professor of economics, management and finance at Quisqueya University. He is the current president of the Association of Haitian Economists.
- Kathleen Dorsainvil received her first degree in economics statistics from the National School of Statistics and Economic Administration (ENSAE) in France and a doctorate in Economics from Penn State University (USA). She worked as an Analyst at Bell Canada and in Haïti as an Advisor to the Finance Minister for eight years. She taught Economics at both graduate and undergraduate levels at Howard University, Winston-Salem State University, Bentley College and American University in the USA. Dorsainvil has presented at numerous professional conferences and was invited to several round table dialogues at the Brookings Institution in Washington, DC.
- Pierre-Marie Boisson is Chairman of the Board of Directors of the SOGESOL, a micro-finance company and a subsidiary of SOGEBANK. He is also the chief economic adviser of the Board of SOGEBANK, Board Member of SOGEXPRESS, another subsidiary of SOGEBANK in the field of remittances, and a member of the Executive Committee of the Foundation SOGEBANK. He is also a member and the current treasurer of the Economic Forum. He worked for two years with the International Finance Corporation (IFC) and has substantial experience in project finance and economic analysis, both nationally and internationally. He writes frequently for the Haitian daily newspaper on macro-economic and financial issues.
Eminent Panel approach
The Eminent Panel sought to address the research proposals with a view to answering the question: To which initiatives should additional resources be spent first? The Eminent Panel intends these findings to be informative not just to the Government of Haiti, but also to NGOs and to international donors.
The panel examined the proposals in detail. Each proposal was discussed with its principal author. The panel was informed by Sector Expert Review papers, and by their own critical appraisals and discussions on assumptions and methodology.
In ordering the proposals, the Eminent Panel was guided predominantly by consideration of social, economic and environmental costs and benefits.
The Eminent Panel acknowledged the difficulties that cost‐benefit analysis must overcome, both in principle and as a practical matter, but agreed that the cost‐benefit approach was an indispensable organizing method.
Each Eminent Panel member assigned his or her own ranking to proposals2 . The Eminent Panel’s ranking was calculated by taking the median of individual rankings. The Eminent Panel jointly endorses the median ordering as representing their agreed view.
Ranking of Proposals
The Eminent Panel considers and prioritizes specific proposals to respond to challenges. This is different from ranking the challenges themselves. A low ranking of a proposal does not mean that the problem it addresses should be considered unimportant.
The ranking of certain proposals including national legal aid system, domestic violence helpline and digitization of government services were affected by factors including the availability of data, and may have been given a lower ranking among other reasons due to concerns that the proposals would not adequately resolve important aspects of the challenges they were designed to address.
However, the Eminent Panel stresses the importance of reducing domestic violence, resolving legal system shortcomings, and improving government services.
Regarding the challenge of domestic violence, the Eminent Panel specifically notes the beneficial effect that higher-ranked proposals are likely to have on this challenge, through financial empowerment of girls and women. Such effects were taken into consideration.
The Eminent Panel also notes the importance of improving wages, particularly for women, as well as the registration of birth and provision of identity documents. It recommends that a broad range of measures be studied, including improvements to the existing system, and that the electronic registration be not considered in isolation.
Careful attention should be paid to the institutional and financial arrangements for implementing these proposals, such as in the case of crop transport truck systems.
In setting priorities, the Eminent Panel took into account the strengths and weaknesses of the specific cost‐benefit appraisals under review, and gave weight both to the institutional preconditions for success and to the demands of ethical or humanitarian importance.
Based on the costs and benefits of the solutions and their own assessment, the panel ranked the proposals, in descending order of desirability, as follows:
|1||reform electricity utility|
|2||wheat flour micronutrient fortification|
|3||early childhood stimulation|
|4||train first responders|
|5||immunization for children 0-1|
|6||maternal and newborn health|
|7||access to contraception|
|8||skilled assistance at delivery|
|9||expand mobile broadband|
|10||electronic port custom system|
|11||electronic registration of birth certificate|
|12||calcium and micronutrients in pregnancy|
|13||micronutrient powder ½-2 year olds|
|14||girls' retention in school|
|15||local child nutrition formula RUTF|
|16||teaching children at the right level|
|17||standard child nutrition formula RUTF|
|19||distribution grid extension and upgrade|
|20||digitize government processes|
|21||shelters for women and children|
|22||national power transmission grid|
|24||manage childhood illnesses|
|25||flood early warning system|
|26||cholera 1 dose school vaccination|
|27||conditional cash transfers secondary school|
|28||mobile school clinics|
|29||rural community health centers|
|30||flood early warning system and shelters|
|31||rural borehole and handpump|
|34||cholera 1 dose mass vaccination|
|35||digitize land records|
|36||rural community led total sanitation|
|37||performance pay in public service|
|38||diabetes treatment for children|
|39||expand urban ambulance network|
|40||expand graduation program|
|41||road Gonaives to P-d-P|
|43||crop transport truck system|
|44||private schools subsidies|
|45||HIV test and treatment|
|46||gas power ACC|
|47||cholera 2 dose mass vaccination|
|48||promote improved cookstoves|
|49||civic education for youth|
|50||clinics at each school|
|51||teach in creole|
|52||national legal aid system|
|54||establish national ambulance network|
|56||national patrol force|
|57||free school uniforms|
|58||off-grid hydro for village|
|59||hypertension campaign and full treatment|
|60||off-grid diesel for village|
|62||expand microcredit program|
|64||introduce crop insurance|
|65||switch charcoal cookstoves to gas|
|66||packaging and conservation center|
|67||domestic violence helpline|
|68||subsidize fertilizer for rice|
|69||urban container based sanitation|
|70||solar photovoltaic power|
|71||bridge Les Anglais|
|72||local content procurement|
|74||pit latrines in urban areas|
|75||diesel, solar and battery for village|
|76||improved and intensified rice production|
|77||switch wood cookstoves to gas|
|78||prevent teen dating violence|
|79||solar reflective power|
|80||vaccinate girls against cervical cancer|
|81||carbon pricing infrastructure|
|82||20% rice tariff for ten years|
|83||increase public service pay 10%|
|84||increase domestic worker wages*|
|85||paid paternity leave|
*The Eminent Panel stresses the importance of increasing wages, especially for women, but the specific proposal considered was not sufficiently clear on the net benefits for the target group.