Inside participants’ responses: Why choose to save lives over cash transfers?
Ethical reasoning of survey respondents in Ghana and Kenya
IDinsight has worked with Givewell to measure the values and preferences of individuals and communities in order to better allocate development funding. This is one of a series of blog posts on our study. We are interested in discussing these results and are open to collaboration on similar future studies. Please contact alice.redfern[@]idinsight.org if you are interested.
While our report provides a statistical overview of people’s preferences and values, individual responses and reasons behind them varied widely. An important component of our study was qualitative interviews, in which we presented a number of different scenarios and trade-offs and captured the individual’s thought process as they respond.
Here, we provide a snapshot of the lives and values reasoning of some of the people we interviewed in Ghana and Kenya. More profiles, summarizing reasonings across a broader range of topics (such as subjective wellbeing), can be found here. [Note that all responses have been anonymized and pseudonyms have been assigned]
I will always choose for the children, anything to support them.
Attah is a 52-year-old man living in Jirapa, Ghana. He lives with his wife, mother, and six children. Attah farms and rears livestock for both subsistence and commercial use. He used to have a small meat-roasting business but closed it because he could not sustain it.
When asked to choose between saving the life of a very sick child and providing enough resources to the rest of the child’s poor family, Attah picks saving the child. He reasons: “Money [contributes] to life; but if you don’t have life itself; you have a problem. Money is value added to life; it helps you to take care of life. [The child] still has a lot of potential to support the family.” However, if instead of a child it is one of the adults in the family who is sick, Attah chooses the cash transfer. He says: “I would pick money in this case…the child cannot look for money [and] cannot go to anyone for support, so needs the treatment. [However], the adult is already grown and [since] he cannot support the house…the cash transfer is [better].”
If Attah could spend $10,000 on either mosquito nets or cash transfers in his village, he would allocate all the money to mosquito nets. This is because he prefers programs that protect children against diseases. He says: “I will always choose for the children, anything to support them. If you have money and you have work to do [but] your child is sick, you cannot do your work. It’s better to have healthy children; [otherwise], you do not have peace of mind.”
Poverty is a disease that is worse than malaria.
Ali is a 48-year-old man living in Kilifi, Kenya. He is the household head of a family of 3, including his wife and children. Ali was born and raised in Northern Kenya. He attended primary school but could not proceed on to high school because his family did not have enough money to pay his school fees. Since primary school, he has worked as a herder, a hawker, a construction worker, and a tourist guide, and he now works a job as a guard at a private residential house.
In general, Ali prefers programs that improve living standards of people to the ones that reduce the risks of dying. He explains: “There is no need to waste money on teaching people how to reduce their risks of dying by telling them to use ITNs[Insecticide Treated Nets] and giving motor bike riders helmets. No matter how much money you spend on such programs, deaths will not reduce because a lot of these are caused more by people’s own decisions or choices to use/not to use the programs such as whether or not to use a helmet. Improving the standards of people is more important because it will occupy people with more meaningful jobs.”
If Ali could spend $10,000 on either mosquito nets or cash transfers in his village, he would allocate all the money to cash transfers. This is because he prefers programs that increase consumption. He reasons: “Poverty is a disease that is worse than malaria. So if 10 families move out of poverty and manage to improve their living standards, they can even be examples to other poor families and demonstrate that it is possible to move out of poverty. It can boost the community by a lot.”
Giving me fertilizer is better than giving me money because I cannot spend the fertilizer on anything else but the farm.
Patience is a 49-year-old woman living in Jirapa, Ghana. She lives with her husband, mother-in-law, son, daughter, stepson, and stepdaughter. Patience has had a leg disability since she was in primary school as a result of a snakebite, limiting the physical activities she can engage in. Her son Eli now provides for the household with his mobile phone airtime business next to the road, and her other children work small jobs. Given elevated medical costs and limited sources of income, Patience has had to constantly take loans over the years to cater for the varied needs in the household.
If Patience could spend $10,000 on either mosquito nets or cash transfers in her village, she would allocate all the money to mosquito nets. According to her, good health outcomes ensure children are able to go to school, which, conversely, enables them to support their families. When asked whether she thinks cash transfers would lead to the same outcomes, she expresses her skepticism about any productive use of the money. She explains: “If they give the money out to individual households, then the tendency is to spend it on alcohol and food, and the money will just be wasted. Even I wouldn’t be disciplined to spend the money on what is productive. So giving me fertilizer is better than giving me money because I cannot spend the fertilizer on anything else but the farm.”