During a cabinet meeting later in the day, the education minister – who is a career schoolteacher – presents a proposal. She is planning to double teachers’ pay and expects this to improve 10th grade scores by 0.1 standard deviations. The prime minister then asks you for your views. What would you say about the relative cost-effectiveness of the early-childhood intervention relative to this proposed policy change?
Later that evening, you reflect on the Norway study and consider whether you should allocate more of the health ministry’s budget to neonatal nutrition programs. Comment on the internal validity and external validity of the Norway study. By internal validity, I mean, do you believe the results of the study and do you think of these estimates as causal? By external validity, I mean, do you expect to find similar effects if you ran a similar program in your own (poor) country? Also note that your country uses 2000 gms as the cutoff to classify children as Very Low Birth Weight.
You decide to read the Norway study in more detail and learn that the neonatal nutrition intervention actually reduced infant mortality. You think, “this seems great! Two birds with one stone”. But then you begin to worry how this might affect the estimated effect on 10th grade math scores. How do you think this selective mortality would bias the estimated effect and why?
You are eventually convinced that neonatal nutrition is something that your government should devote considerably more resources to, and give a speech about this issue at the annual convention of your political party. However, most of your party members don’t seem interested in this as they don’t think it will be a good political strategy. Explain why there may be limited political returns for early-life health investments.