Thanks so much, Ben! We've appreciated our discussions with you the last few months about your work with MHI and MSI's last mile programming.

Thank you so much for your thoughtful comment and for sharing the research on post-partum depression which we look forward to reviewing. Thanks also for your questions about DALYs and maternal deaths averted. We will provide more information shortly!

Thanks so much, we will share more soon!

These cost effectiveness numbers are based on the total costs of our Outreach and Public Sector Strengthening programs in Nigeria and our impact based on services delivered through these channels and calculated using our Impact 2 tool. Costs include all actual expenses to MSI involved in delivering services through these two channels, for example, for our outreach teams, these costs encompass service and non service providers, consumables, travel, demand generation, quality assurance, and other overhead expenses associated with providing services on-site (such as Research, Monitoring and Evaluation). This also includes MSI's indirect costs.

For impact estimates, such as the number of maternal deaths averted, we utilize our Impact 2. This is an open-source, peer-reviewed tool that models bottom up estimates based on the services our teams deliver on the ground. The modelling is based on best available data from reputable sources such as WHO, UN, World Bank etc.

You can read more about Impact 2 via this introductory guide here: https://www.msichoices.org/wp-content/uploads/2023/10/impact-2-introductory-guide-june-2018-1.pdf

The full methodology paper can be found here: https://www.msichoices.org/wp-content/uploads/2023/10/impact-26-methodology-paper-2023.pdf

You can download the tool here: https://www.msichoices.org/what-we-do/technical-expertise/impact-2/

We will be publishing a follow-up blog with a deep dive on our Nigerian program and its cost effectiveness calculations soon.