Haiti Priorise Outcome Presentation

1. Top 10prioritized solutions for Haiti
Ministryof Planning, Port-au-PrinceMay 3rd, 2017

2. • Andlots ofsmartsolutions
LotsofChallenges

3. Butwhatgetsthemostattention?

7. Thatisnothowtoprioritize

8. So,howshouldyouprioritize?

9. Toprioritizeyouneedamenu
• With prices andsizes

16. • Weestimate allthe costs in gourde
• Typically economic, but also social and environmental
• Weestimate allthebenefits ingourde
• Both social, environmental, and economic
• Andgive youthe benefit-costratio
• Where doyou do the most good forevery gourde?
Menufordoinggood

17. • Stakeholderengagement
• Meetings and presentation on the Copenhagen Consensus methodology were held with various government ministries, Haiti's main
developmentpartners (USAID, UN, European Union,World Bank, IDB), civil society and the private sector.
• Sectorexpertroundtables
• 17 roundtables were held togather suggested interventionsfrom sector experts. Themesincluded gender, decentralization,
economicdrivers of growth, health systems, education, environment,among others.
• Vetting ofinterventions
• Criteriafor vettingtheinterventionsweredevelopedin collaborationwiththeAdvisoryCouncil (PierreMarie Boisson,
KathleenDorsainvil,Camille Chalmersand Eddy Labossiere).The interventionswerevettedby sectorexperts,ministries,
developmentpartners,andtheprojectteam.
Projectmethodology

18. • Eminent Panel
• April 30-May2all economiststravelledto Port-au-Princeto presenttheir findingsfor aneminentpanel
• KetleenFlorestal
• RaymondMagloire
• VernonSmith
• KesnerPharel
Projectmethodology

19. Thetop10developmentsolutions

20. 10.electronicportcustomsystem

21. Computerization of procedures at the Port of Cap-Haitien
Yvrose GUERRIER and Jeff ALLIEN
Ministry of Planning and External Cooperation (MPEC)
Haiti Priorise, Conference from April 29 to May 3, 2017, Port-au-Prince

22. Introduction
 The cost of handling a standard container is US$445 at Varreux Terminal,
US$121 at Puerto Rico, US$109 at St-Domingue (World Bank, "Trade and
Competitiveness Global Practice";
Clearance time: 4 to 8 days compared to a time limit of less than 24 hours in
other Caribbean countries (World Bank, 2014);
According to the World Bank, in 2014 the prevailing logistics costs of the port
crossing, at the national level, are US$1555 per import container and US$1200
export;
 International trade impeded.

23. Calculation and description of
intervention costs
Cost Elements Value in gourdes
Acquisition of necessary goods and services 277,739,200.00
Installation of Single Window Electronic Port 339,924,792.00
Training of System Operators (Single Window
and Port Computing System) 5,548,800.00
Annual salary increase for trained technicians 29,808,000.00
Care and Maintenance 159,219,513.24
Electrical work 26,079,684.36
Total costs 838,319,989.60

24. Calculation and description of the benefits of
the intervention
Description Value in gourdes
Annual resource savings related to
travel restrictions 1,320,000.00
Annual customs catch earned with the
intervention 1,226,228,788.07
Annual Currency Gain 159,813,544.03
Annual revenue earned from reduced
smuggling 4,325,996,165.28
Reduction in port services prices 1,993,286,881.57
Total 7,706,645,378.95

25. Benefit-Cost Ratio
Intervention Reduction Benefit Cost BCR
Quality of
evidence
Computeriza
tion of
procedures
at the
international
port of Cap-
Haïtien
3%6,349,640,093
799,854,513.30
7.9385
Medium
5%5,250,995,918 753,455,269.50 6.9692
12%2,846,276,781 632,676,163.76 4.4988

26. 9.expandmobilebroadband

27. Digitizing Haiti
Dr Pantelis Koutroumpis
Imperial College London

28. Digitization elsewhere
Does it matter for the economy?
• Fixed Line – the impact of adoption:
• World Bank (66-countries for 1980-2002): “an increase of 10 lines in 100 inhabitants in high-income economies can increase (GDP) per
capita by 1.21 percentage points”.
• Koutroumpis (22 OECD countries for 2002-2007) found a 0.24% average annual effect from broadband adoption. Identified that a critical
mass of users needs to be in place before the larger effects begin to emerge. This level of adoption practically translates into half of the
population being connected to the Internet.
• Czernich et al (OECD panel for 1996-2007) and found an equivalent effect of “0.9-1.5% for the addition of 10 more broadband lines in 100
people”.
• Mobile lines – the impact of adoption by generation:
• Gruber and Koutroumpis (192 countries for 1990-2007) estimated a 0.2% annual GDP effect from mobile communications and a direct
increase in productivity.
• Koutroumpis and Cave (49 countries for the period 2000-2015) estimated the mobile broadband effect for various generations of mobile
access. “The transition from 2G to 4G for a country with 100% penetration increases the annual GDP effect by 1%”. A similar effect is
achieved if the same country grows from 75% adoption to 100% in the case of 2G networks.
• Users also value a “good connection”:
• Ahlfeldt et al (2016) linked willingness to pay for broadband speeds with property prices in the UK and found a strong effect that increases
with speed at a decreasing rate. They analyzed a large micro-dataset of millions of properties for the period 1995-2010 and reported a
2.8% increase in property price for an ADSL connection (up to 8MBps) and this grows to 3.8% in case a house is connected to an ADSL2+
connection (up to 24MBps).
• Rosston et al. (2010) estimate the demand from an online US survey for various levels of broadband speed and report that the
representative household is willing to pay 48$ a month for an improving from slow to very fast connection speeds.

31. Get 50% of Haitians on broadband
• Why not with fixed line?
• A fixed broadband connection (FTTx) from Digicel costs from 55$/month ~80% of the average annual income just for Internet access. Higher speeds
cost even more reaching up to 220$/month a cost more than three times the average income and almost 100 times higher than the income of the
majority of Haitians.
• The cost of a basic computer ranges from 500$-600$ which is prohibitive for many people in the country.
• Increase mobile broadband penetration to 50% in 5 years and install an undersea cable to support the increased traffic
• Currently the most popular plans in the country include 50MB or 100MB of data use from mobile phones and these are predominantly prepaid
(99%).
Steps to achieve this target:
1. Install an additional undersea cable to increase international
connectivity (to allow for higher speeds in fixed and mobile
connections)
2. Build or upgrade infrastructure to increase 4G broadband coverage
and capacity to 50% population for specific usage baskets (from
100Mb to 1Gb per subscriber per month) prioritise the major cities
like Port au Prince to reduce initial adoption risks)
The benefits from the use of the services will stem from the adoption process.
For this purpose I envisage a gradual transition of existing subscribers to 4G
and a 50% penetration rate for mobile broadband by 2021. The adoption path
presented is relatively insensitive to the actual growth rate until 2021 as long as
the adoption target is reached within the specified timeframe.

32. Total costs, benefits and BCRs
Intervention Discount
Benefit (billion
gourdes)
Cost (billion
gourdes)
BCR
Increase mobile
broadband penetration to
50% in 5 years &
install an undersea cable
to support the
increased traffic
3% 1,097.7 80.1 13.70
5% 685.7 56.1 12.22
12% 166.9 20.3 8.22
In 2050 due to this interventions:
• the average citizen will get 14,895 gourdes due to
this intervention – of course large heterogeneity in
the distribution of these benefits.
• The GDP will be 16% higher compared to the
baseline scenario
• Haiti will have a reliable telecom infrastructure
covering different types of use (agriculture, services,
health, education, etc.)

33. 8.skilledassistanceatdelivery

34. Providing skilled care
before and during birth
Karin Stenberg, World Health Organization
Ludovic Queuille, Panamerican Health Organization, Port-au-Prince, Haiti
Rachel Sanders, Avenir Health, Washington DC, USA
Marcus Cadet, Ministry of Public Health and Population, Port-au-Prince, Haiti
Haiti Priorise conference, Port-au-Prince April 29-May 2, 2017

35. High rates of maternal and newborn mortality
• Progress made, but access to skilled maternity care remains limited
• 37% - births with skilled assistance (EMMUS V, 2012) vs 20,6% in 1995/1995 (EMMUS II, 1994-1995)
• 359 - Maternal Mortality Ratio (MMR = deaths per 100,000 live births) in 2015 (UN estimate) while
EMMUS IV estimated 630 in 2005-2006
• 1 in 90 – the risk that Haitian women have of dying due to pregnancy or child birth (UN).
• 3 maternal deaths, 17 stillbirths, and 18 newborn deaths – occur every day (UN)
• These deaths are largely preventable, and a big societal loss
• The intrinsic value of health
• Intergenerational effects
• Orphans at risk of mortality, illness, vulnerability
• Broader societal consequences
• Reduced household financial stability, social stability
• Lower economic growth (productivity loss)

36. 1st analyzed solution
Access to skilled assistance during birth
Photo UNFPA

37. Access to skilled assistance during birth
Skilled assistance at birth for normal
(uncomplicated) delivery
(SBA normal delivery – P2)
Midwifes working in teams, provide care for
• Normal delivery
• Neonatal resuscitation
• Clean postnatal practices
Skilled assistance at birth including referral and
management of complications
(SBA-comprehensive – P3)
Midwifes working in teams, provide and manage:
• Emergency obstetric care
• Maternal complications
• Newborn complications
Demonstrated cost-effectiveness: Adam et al (2005), DCP3 (2016)

38. Estimating costs
• Inputs-based costing, by year:
• Commodities: drugs, supplies
• Supply chain costs and commodity waste
• Service delivery (inpatient & outpatient) operational costs
• Midwife salaries
• Training midwifes (1 midwife per 175 births/year)
• Programme support
• Cost per birth
• Normal, without complications USD2014 93 / HTG2014 4205
• Comprehensive, with mgt complications USD 2014 128 / HTG2014
5788
• WHO Spectrum-GCEA/ UN-OneHealth Tool (LiST)
• Projected number of births and complications 2017-2036
• A comprehensive, country-tailored analysis

39. Estimating benefits
• SBA-normal averts > 1,700 deaths/year
• SBA-comprehensive > 5,200 deaths/year
• Newborn deaths strongest contributor to
health outcomes
• Averted deaths converted to Healthy Life
Years (HLYs)
• HLYs valued at 1, 3 and 8 x GDP/capita
Deaths averted per year
• Interventions act on specific cause of death

40. Benefit-Cost Ratios
Intervention
Discount
rate
Benefits 2018-
2036
(HTG bn)
Costs
2018-2036
(HTG bn) BCR
Skilled assistance for
normal delivery
3% 105 9 11.6
5% 59 8 7.8
12% 15 5 3.4
Skilled delivery including
referral and
management of
complications
3% 312 12 25.9
5% 177 10 17.5
12% 46 6 7.5
Benefits are valued at 3x GDP

41. 7.accesstocontraception

47. 6.maternalandnewbornhealth

48. Providing skilled care
before and during birth
Karin Stenberg, World Health Organization
Ludovic Queuille, Panamerican Health Organization, Port-au-Prince, Haiti
Rachel Sanders, Avenir Health, Washington DC, USA
Marcus Cadet, Ministry of Public Health and Population, Port-au-Prince, Haiti
Haiti Priorise conference, Port-au-Prince April 29-May 2, 2017

49. 2nd analyzed solution
Antenatal care + a broader Maternal and Newborn
care package

50. Antenatal care + a broader Maternal and Newborn
care package
Antenatal care • Tetanus toxoid immunization
• Syphilis detection and treatment
• Ectopic pregnancy case management
• Hypertensive disorder case management
• Management of pre-eclampsia (with magnesium sulphate)
An expanded comprehensive maternal and
newborn care package
• Antenatal care (P1), as above
• SBA-normal (P2)
• SBA-comprehensive (P3)
• Safe abortion and post abortion care

51. Estimating costs
• Same approach as above (detailed inputs per service)
• Cost per birth:
• Antenatal care USD2014 82 ( HTG 3,708)
• Expanded package USD2014 135 ( HTG 6,105)
• Cost per capita to reach 95% coverage:
• Antenatal care: USD 1.15 (HTG 52)
• Expanded package: USD 1.95 (HTG 88)
• Average annual cost (USD2014 ) for 95% coverage:
• Antenatal care: USD 14 million (HTG 633 million)
• Expanded package: USD 23.5 million (HTG 1,063 million )

52. Estimating benefits (health outcomes)
Maternal Mortality Ratio
The expanded
comprehensive
package (P5) would
reduce MMR by 65%
-
2,000
4,000
6,000
8,000
P1 P2 P3 P5
Maternal Newborn Stillbirths
Deaths averted by year

53. Benefit-Cost Ratios
Benefits are valued at 3x GDP
Intervention Discount
Benefits
2018-2036
(HTG bn)
Costs
2018-2036
(HTG bn) BCR
Antenatal care
3% 44 8 5.9
5% 25 6 4.0
12% 7 4 1.7
Expanded
Comprehensive
package
3% 348 13 26.0
5% 198 11 17.6
12% 51 7 7.6
BCR (5% discount rate)
0
5
10
15
20

54. 5.immunizationforchildren0-1

55. FULL IMMUNIZATION FOR CHILDREN
UNDER 1 YEAR OLD
Magdine Flore Rozier Balde,
Assistant Unit Manager/Economist
Ministry of Planning and External Cooperation
Haiti Priorise Conference, Port-au-Prince, April 29th – May 3rd 2017

56. Justification for the intervention
• High infant mortality rate in Haiti (the highest in the Caribbean)
- 59 per 1,000 live births
Vaccine-preventable diseases (neonatal tetanus, measles……) remain one of the main causes of death
among newborns (close to 2 out of 10)
• Low immunization coverage in Haiti
- 45 children out of 100 are immunized
• Lack of qualified personnel for Extended Program for Immunization (EPI)
- Only 41% of the 644 health institutions have care providers trained in vaccination

57. solution
Full immunization for children under 1 year old

58. Description of solution
The vaccination intervention for children less than 1 year old aims to strengthen immunization services in existing health
institutions nationwide over a period of five years. There are two components:
1) Establishment of qualified personnel in health institutions
• Training personnel on services in the EPI
2) Availability of basic immunization equipment needed for administering vaccines
• All vaccines included in the immunization schedule established by the MSPP in accordance with recommedenations
of the WHO*
• Injection material (needles, cotton etc.)
This intervention will allow the national rate of immunization coverage to gradually increase in order to reach 60% in
2017, 70% in 2018, 80% in 2019, and finally 90% by 2020 or 2021

59. Intervention Costs
Estimation of the costs of immunization for children under 1 year old over a 5 year
period
• In 2016,the cost of vaccination is 78 USD (approximately 5300 gourdes) per
child. 864,846 will be vaccinated as part of the intervention.
• Cost of injection material, transportation, and maintenance is 160 million
gourdes
• Cost of training is 69.2 millions gourdes
Total cost of the intervention is 2.4 billion gourdes

60. Intervention Benefits
• Reduction in infant mortality
16,506 children’s lives saved, with an average life expectancy of 70
This has positive economic benefits for the country since, as a
general rule, each year of life gained is evaluated at three times
the GDP.
• Savings for the parents
The work time lost by parents because a child’s illness represents a
loss of earning estimated at more than 281 million gourdes.
• Savings for the healthcare system
More than 16 million gourdes are saved by the healthcare system
in curative care for children with an ARI
Overall, the benefits equal over 32,3 billion gourdes
235,873 235,969 235,943 235,790 235,827
314,497
367,063
419,454
471,580 471,654
2017 2018 2019 2020 2021
Evolution of the number of babies vaccinate from
2017 to 2021
(situation with intervention and without
intervention)
Evolution without the Evolution with the

61. Total costs and benefits and benefit-cost ratio
Table of Final Results
All cost and benefits amounts are in Gourdes
Intervention Discount Benefit Cost BCR Quality of Evidence
Full Immunization children under 1
3% 51,700,040,844 2,515,927,655 21
High5% 32,298,188,123 2,411,997,070 13
12% 11,003,713,106 2,105,122,115 5

62. 4.trainfirstresponders

63. R. Christina Daurisca
Applied Economist
Ministry of Public Health and Population, Contracting Unit
Haiti Priorise, Port-au-Prince, April 29-May 3, 2017
Ambulance System and Network

64. Why develop the ambulance network?
 After a trauma, a source of preventable deaths and disabilities, every
minute counts
 50% reduction of medically preventable deaths with the establishment of
a treatment system
 Currently, the rate of access to ambulance services is equal to <2% of the
population having suffered from an emergency
 Ambulance center: in number only 1, based in PAP, <100 ambulances for
more than 11 million inhabitants, rugged terrain and hard-to-reach areas

65. Intervention 3: First Responders and
Paramedics 1/2
 Use of volunteers at the
community level (TBAs,
teachers, etc.) to provide
first aid
 2500 people per 1 million
inhabitants
 Total Costs
80,369,344 gourdes
Types
Percenta
ge
reduction
in deaths
Number of
deaths
avoided
DALYS
(non-
reduced
)
Death
related to
trauma 9% 715 34
Benefits
(in monetary value)
1,266,324,056
gourdes

66. Intervention 3: First Responders and Paramedics
2/2
Discount Benefit Cost
Cost-
benefit
ratio
3% 1 652 560 474
80 369 344
344 20.6
5% 1 266 324 056 80 369 344 15.8
12% 637 862 961
80 369 344
344 7.9

67. 3.earlychildhoodstimulation

68. Education in Haiti
Atonu Rabbani
Department of Economics, University of Dhaka
Haiti Priorities Conference, Port Au Prince, 29/4-02/05

69. What Early Childhood Education (ECE) constitutes?
• Human capital/skill formation starts early in life (“Heckman
Equation”)
• Education policy in Haiti also recognizes this
• A regular classroom intervention for 4 and 5 year olds
• In batches of 40 students with two trained educators with an assistant
• Standard practices include cognitive stimulants (with toys and accessories) as
well as social skills

70. Costs
• Total cost for a center will be about USD 6,300/year
• Or about USD 2017 $157 per child per year
• Targeting 258 thousand children (= 50% of 4 and 5 year olds in Haiti)
• Total cost = about USD 102m for a two-year program
• Includes fixed costs of trainings, toys, accessories, curriculum development
and also working costs of teachers’ salaries and rents
• Also the cost of additional 0.61 year of schooling

71. Benefits
• About 35 percent gain in income
• Gain from 16 to 55 years
• 2.7% annual real wage growth
• Total discounted benefit: About
30 thousand USD
• Possibly other non-market
benefits (lower criminality, better
health), so lower bound
-200
0
200
400
600
800
1000
1200
1400
4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 55
CostandBenefit,USD
Cost Benefit

72. Benefit Cost Ratios (BCRs) for ECE
• Benefits and costs
figures are in billion
LCUs
Discount Benefit Cost BCR
Quality of
Evidence
3% 203.31 7.11 24.7
Strong5% 114.53 6.93 13.9
12% 22.96 6.41 2.6

73. 2.wheatflour
micronutrientfortification

74. Preventive Nutrition
Interventions
Reina Engle-Stone, Christine P Stewart, Hanqi Luo, Stephen A Vosti,
Katie Adams
University of California, Davis
Haiti Priorise conference, April 28-May 3, 2017

75. Inadequate micronutrient nutrition affects health
and development
• Women of reproductive age and young children are most
vulnerable
• Anemia in pregnancy (53.9% in Haiti) is associated with
increased risk of infant mortality, and preterm birth and low birth
weight (which have long term consequences for infant)
• Calcium supplementation to pregnant women reduces the risk of
pre-eclampsia, which increases risk of maternal mortality.
• Sufficient folic acid at the time of conception reduces the risk of
neural tube defects (500+ cases/year in Haiti), which are usually
either fatal or result in severe disability.
• Fortification delivers folic acid early enough to reduce NTDs
• Consistent reductions in NTDs observed following folic acid
fortification in other countries

76. Inadequate micronutrient nutrition affects health
and development
• Anemia prevalence in Haiti
• 45.3% (rural) to 53.9% (urban) among women of reproductive age
• 64.5% (rural) to 66.0% (urban) among preschool children
• 50% of anemia assumed to be caused by iron deficiency
• Programs to increase iron intake (food fortification, supplements)
reduce the risk of iron deficiency anemia
Summary: high burden of death and disability from micronutrient deficiencies

77. Wheat flour fortification with
iron and folic acid

78. Addition of iron and folic acid to industrially
produced wheat flour
• Flour fortification programs being scaled up globally  growing
experience in implementation in LMICs
• Wheat is imported and milled in Haiti (centralized/few millers; small %
imported as wheat flour)
• Concentrated micronutrient premix mixed into flour
• Reaches all consumers of wheat flour (41% urban, 34% rural)
• Reach estimated from ECVMAS household survey data (defined as
households purchasing bread 3-4 times in past week)
0%
100%
2017 2022 2027
% of flour adequately
fortified
 % of flour adequately
fortified is assumed to scale
up gradually to 95% beginning
in year 6

79. Costs of wheat flour fortification
• Startup costs
• 47,214,375 Gourdes in Y1
• Equipment
• Micronutrient survey
• Revisiting norms
• Recurring costs
• 42,417,810 Gourdes in Y12)
• Micronutrient premix (90+% of annual costs in Year 12)
• Monitoring and evaluation
• Additional periodic costs included to replace
equipment and conduct evaluation surveys
0
50,000,000
100,000,000
2017 2022 2027
Program cost, Gourdes
per year

80. Benefits: DALYs averted
• Decrease in deaths due to neural tube defects by folic acid
• Decrease in iron deficiency anemia
• Women of reproductive age (15-49 y)
• School age children (5-14 y)
• Preschool children (6mo-4 y)
After scaling up to 95% fortified:
• 140+ cases of neural tube defects
averted annually (assume 100%
mortality)
• Number of cases of anemia averted
annually (1 year duration)
• 92,000+ women
• 100,000+ school-age children
• 61,000+ preschool children
0
10000
20000
30000
40000
Total DALYs over 12 y, 3%
discount

81. Total benefits, total costs, and cost-benefit ratios
Valuation of
DALYs
Discount Rate
Benefit
(in Gourdes)
Cost
(in Gourdes)
BCR
3 X GDP 5% 7,938,064,315 331,312,834 24
Sensitivity analyses showed favorable BCRs even if
reductions in iron deficiency anemia among children are
not included
(e.g., if young children eat less wheat flour than assumed)

82. 1.reformelectricityutility

83. LIMESTONE ANALYTICS
Benefit-Cost Analysis of Interventions in Haiti’s
Electricity Sector:
Institutional Reform
Authors:
Juan A. B. Belt (lead author), Bahman Kashi, Jay Mackinnon, Nicolas Allien
Haiti Priorise: May 1st, 2017
Organized by the Copenhagen Consensus Centre

84. Per-capita Consumption of Electricity (kWh)
114

85. Key Problems/Issues
• Very high ATC&C losses: 70% of which 21% technical
• EDH composed of 10 separate unconnected units; reduced opportunities for
economies of scale & scope
• No corporatization of EDH, a prerequisite for reform
• Low electrification rate: 12% connected legally to the grid & an perhaps up to
20% connected illegally
• Daily blackouts: 5-15 hours of electricity per day
• Self generation is prevalent but costly
• EDH is insolvent and requires an annual subsidy of around 200 Million USD.
• Alleged corruption, particularly in Port au Prince
• Bad use of external advisors
115

86. Proposed Intervention:
Phase I
• Strengthening Ministry & Regulator
• Determining cost-reflective tariff for efficient enterprises; estimating
RPI-X
• Corporatization of EDH’s 10 units
• Preparation of bid documents for management contracts, leases,
concessions & privatization
Phase II only funded if Phase I succeeds
• Support for EDH with management contracts & some CAPEX
116

87. Proposed Phases:
Phase I
• Duration 3 years
• Corporatization of EDH’s 10 units
• Preparation of bid documents for management contracts, leases,
concessions & privatization
• Strengthening Ministry & Regulator
• Establishing cost reflective tariffs
Phase II
• Only funded if targets are met in Phase I
• Support for EDH with management contracts & limited CAPEX
• Part 1 (Donor funded, lasts 5 years)
• Part 2 (Continued with EDH support)
117

88. Benefits
Present losses:
• Technical 21%; Non-technical 49%
• Total 70%
Potential reduction in losses
• Based on USAID project supporting Kabul distribution company
(DABS)
• For Haiti, it was assumed that the loss reduction would take twice as
long, 10 years as opposed to five
• ATC&C losses would decline from 70% to 15% in a 10 year period
118

89. Probable Benefits not Included
• Value of reduced public subsidies may have greater
benefits if well-invested in public or merit goods
• Strengthening the financial position of the utility would
make it more viable and able to invest in efficiency
measures & able to procure power at lower costs
• World Bank concludes that when users are charged they
reduce their consumption by 50%. This additional power
available would reduce the costs of load shedding & self-
generation by an amount likely to exceed the revenue
119

90. Summary - Costs, and Benefits (by Stakeholder)
120
Note: Above figures assume 12% discounting, targets of 10.5 and 4.5 percent for commercial
and technical losses (respectively),100% probability of success in Phase I, and 33 year project length.
Country
Reform Partnership Non-Paying
Customers
Total
Benefits Donor EDH
Reduction in commercial losses 000,000 USD 359 (359) 0
Reduction in technical losses 000,000 USD 154 154
Costs
Phase I costs 000,000 USD 10 10
Phase II (Part 1) costs 000,000 USD 20 20
Phase II (Part 2) costs 000,000 USD 5 5
Net impact 000,000 USD (30) 508 (359) 119

91. Summary – Costs, Benefits, BCRs
121
Economic EDH
Discounting
Rate
Expected Benefits,
Present Value
(Million USD)
Expected Costs,
Present Value
(Million USD)
BCR
Expected Benefits,
Present Value
(Million USD)
Expected Costs,
Present Value
(Million USD)
3% 308.26 38.87 7.93 1,027.53 26.43
5% 216.78 33.30 6.51 722.61 21.70
12% 77.00 22.28 3.46 256.67 11.52
Note: Figures above assume a 50% probability of success in Phase I.
BCR for EDH exceeds 100.

92. Totallistofopportunities
Starts the conversation on priorities in Haiti

93. 12
7
4.7
2.3
1.5
11
10
5
3.6
2.6
1.9
1.0
7
4.2
3.9
2.2
1.3
3.7
3.0
2.6
2.2
1.9
1.3
1.3
1.2
0.8
0.8
3.1
1.4
1.4
1.2
1.1
2.2
2.2
1.1
1.0
0.9
expand mobilebroadband
electronicport custom system
digitizegovernmentprocesses
road Gonaives to P-d-P
bridgeLes Anglais
electronicregistration of birthcertificate
decentralized government
e-voting
performance pay inpublicservice
digitizeland records
national patrol force
increasepublic servicepay 10%
flood early warningsystem
flood early warningsystem and shelters
promote improved cookstoves
switch charcoal cookstoves to gas
switch wood cookstoves to gas
subsidizefertilizer for rice
better agroforestry
crop transport truck system
biogas scale-up
introduce crop insurance
carbonpricing infrastructure
agricultural R&D
packaging and conservationcenter
20% ricetarifffor tenyears
improved and intensified rice production
expand graduation program
off-grid hydro for village
off-grid diesel for village
diesel, solar andbattery for village
expand microcredit program
local contentprocurement
rural boreholeand handpump
rural community led total sanitation
urban container based sanitation
pitlatrines inurbanareas
24
10
10
9
8
22
10
6
2.5
2.0
1.5
1.4
1.0
0.5
18
11
8
4.4
1.3
1.0
17
9
8
6
5
4.9
3.0
2.9
2.0
16
8
6
4.0
3.9
2.8
14
12
2.8
1.0
13
8
6
3.6
3.5
3.1
2.1
1.7
0.8
wheat flour micronutrientfortification
calcium and micronutrients inpregnancy
local child nutritionformula RUTF
standard child nutritionformula RUTF
micronutrientpowder ½-2 year olds
reform electricity utility
distributiongrid extensionand upgrade
national power transmission grid
gas power ACC
coal power
hydro power
wind power
solar photovoltaicpower
solar reflectivepower
access to contraception
maternal and newborn health
skilled assistanceatdelivery
girls' retentionin school
paid paternity leave
increasedomesticworker wages
early childhood stimulation
teaching childrenattherightlevel
teach increole
train teachers
conditional cashtransfers secondaryschool
civiceducation for youth
free school uniforms
privateschools subsidies
vocational training
train firstresponders
expand urban ambulance network
mobileschool clinics
rural community health centers
clinics ateach school
establishnational ambulance network
shelters for women andchildren
domestic violencehelpline
national legal aid system
preventteen dating violence
immunization for children0-1
managechildhood illnesses
cholera 1dose school vaccination
diabetes treatmentfor children
cholera 1dose mass vaccination
HIV test and treatment
cholera 2dose mass vaccination
hypertensioncampaignand full treatment
vaccinategirls against cervical cancer
SOCIAL,ECONOMICANDENVIRONMENTAL
BENEFITS FOR EVERY GOURDE SPENT
equality
education
health:infrastructure
nutrition
electricityandenergy
justice
health:diseases
infrastructure
poverty
government
naturaldisasters
airpollution
agriculture
economy
waterandsanitation