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Copenhagen Consensus Center

Haïti Priorise Eminent Panel Findings

Port-au-Prince, May 3 2017

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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
billion gourdes.

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
billion gourdes.

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:

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.

Advisory Council

The Haïti Priorise project was guided by an Advisory Council that comprises:

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:


Rank Proposal
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
18 decentralized government
19 distribution grid extension and upgrade
20 digitize government processes
21 shelters for women and children
22 national power transmission grid
23 train teachers
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
32 vocational training
33 better agroforestry
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
42 e-voting
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
53 biogas scale-up
54 establish national ambulance network
55 coal power
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
61 hydro power
62 expand microcredit program
63 wind power
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
73 agricultural R&D
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.