The wellbeing cost-effectiveness of the Shamiri Institute
Summary
We evaluate the wellbeing cost-effectiveness (in wellbeing-adjusted life years or WELLBYs) of the Shamiri Institute, an NGO that primarily focuses on scaling mental health interventions across secondary schools in Kenya and secondarily contributes to advancing research on improving youth mental health in Africa. We focus on estimating the effectiveness of its current primary programme, the Shamiri intervention. The intervention consists of 4 sessions of positive-psychology-influenced group therapy, delivered by recent high school graduates (i.e., non-experts given training and supervision by experts) to anyone who signs up, regardless of their level of mental distress.
In 2024, they provided therapy to a student at a cost of $24, accounting for overhead costs. Their variable cost is much lower, implying that if they scale dramatically, they could reduce costs further (to $15 per person in the extreme).
We evaluate their impact based on three approaches (after accounting for duration, spillovers, and adjustments). The first two, which we are more confident in, find similar outcomes, while the third, much more uncertain approach, finds a smaller effect:
- Using 2 Shamiri RCTs of their programme (0.79 WELLBYs)
- Predicting their effect based on evidence from psychotherapy in general (0.88 WELLBYs) from our previous meta-analysis (McGuire et al., 2024b) with different adjustments.
- Based on taking pre-post information from Shamiri and pseudo-synthesising a control group. (0.56 WELLBYs).
These effects are smaller than what we estimate for other psychotherapy charities (0.80 and 1.80 WELLBYs for Friendship Bench and StrongMinds, respectively; McGuire et al., 2024b). The effects are smaller because we think that these effects are strongly driven by the subset of adolescents with baseline distress (who constitute 44% of the student population), whereas Shamiri is delivered to everyone who signs up for counselling.
This implies a cost-effectiveness of 32.93 to 36.80 WELLBYs per $1,000 donated (WBp1k), for the two methods we are more certain about (23 WBp1k for the uncertain model). Either way, this is lower than the cost-effectiveness of our Top Charities, which are currently 40 to 49 WBp1k, meaning that we don’t recommend Shamiri as a Promising or Top charity (see here for explanation of these categories).
However, we think that Shamiri’s strong research culture, dedication to cost-effectiveness and willingness to experiment provides a path to achieving and evidencing a higher cost-effectiveness, which would be more competitive with our Top Charities. This promise, in combination with their presently reasonable level of cost-effectiveness (3-5 times the cost-effectiveness of GiveDirectly cash transfers), results in us recommending them as an Honourable Mention. We plan to reevaluate Shamiri in the future, once they have produced more research.
Notes and acknowledgements
Summary spreadsheet note: There is a summary spreadsheet available. But note that part of our analysis is conducted in R and explained in the report.
Author note: Joel McGuire and Samuel Dupret contributed to the conceptualisation, investigation, analysis, data curation, and writing of the project. Michael Plant contributed to the supervision and writing.
The views expressed in this document are those of HLI staff and do not necessarily reflect the perspectives of external reviewers or employees of the evaluated charities.
Charity information note: We thank Katherine Venturo-Conerly, Tom Osborn, and Rahim Daya for their collaboration and review.
AI note: We used LLMs to a limited extent to help with the wording of some paragraphs and to help expedite the graph coding process.