Will GiveWell fund Chlorhexidine for umbilical cord care by 1st January 2027?
11
38
4.2K
2026
34%
chance

This question resolves positively if GiveWell gives a grant or publishes a recommendation that grants be given to fund Chlorhexidine for umbilical cord care on or before December 31, 2026. Or if a charity undertaking the same work is designated a "Top Charity" or a recipient of "All Funds" before the deadline. This resolves according to a statement from GiveWell or a credible news organisation.

 

It resolves "No" otherwise.

 

The most likely resolution mechanism is that GiveWell writes "yes" in the column "Have we recommended one or more grants to support this program?" in the “Chlorhexidine for umbilical cord care” row of the GiveWell program reviews spreadsheet (https://docs.google.com/spreadsheets/d/1TG7WRU85p1SEjir-5qvIEg4kVG9a4Lnzdgwcub8aKSs/edit#gid=0) or a spreadsheet that supersedes it.

 

N.B. The funds must go towards the distribution of chlorhexidine for umbilical cord care, not a charity that largely does other work.

-- Note --

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-- Background --

GiveWell has recommended grants to over 10 charities over the years. They are currently investigating 12 charity areas with other areas of research in the pipeline including Chlorhexidine for umbilical cord care.**

The following sections are quoted from GiveWell’s explanation of the topic 

“Neonatal mortality is high in low- and middle-income countries, and infection is an important contributing factor to mortality in the neonatal period...

UNICEF estimates that in 2019, 2.4 million infants died in the first 28 days of life. Neonatal mortality, or the death of a newborn in the first four weeks of life, is a problem largely confined to low and middle-income countries, according to WHO. One paper estimates that Sub-Saharan Africa and South Asia comprise 79 percent of global neonatal mortality...

Chlorhexidine (CHX) is a topical antiseptic.6 When applied to the newborn umbilical stump at birth and/or daily in the weeks after birth, CHX may prevent bacterial colonization of the umbilical cord,7 resulting in fewer infections and deaths. In this review, we focus on the delivery of CHX by community health workers. Studies described here included participants with both home and facility-based deliveries…

Current WHO recommendations for umbilical cord care support the application of CHX for home-based deliveries in high neonatal mortality settings (i.e. settings with 30 or more neonatal deaths per 1,000 live births)...

Overall, we believe there is strong evidence that topical CHX applied to the umbilical cord stump reduces neonatal mortality in the community setting. We are highly uncertain about how these effects will generalize, however, and expect there to be meaningful differences by region and/or baseline neonatal mortality rate...

[GiveWell has] found that CHX application is associated with a 15% reduction in neonatal mortality across studies (95% confidence interval -2% to 29%),15 but there were meaningful differences in the size of the effect across studies that are unlikely to be due to chance…

This intervention was found to reduce the incidence of omphalitis, but our cost-effectiveness model only incorporates benefits due to reductions in neonatal mortality. There is evidence of a long-term neuro-developmental cost associated with certain neonatal infections. Due to a lack of evidence regarding the incidence of these severe infections among cases of neonatal omphalitis and uncertainty around the omphalitis findings, we did not incorporate this into our model. By not taking these benefits into account, the model may underestimate the overall benefit of the program. We may investigate this further…

We believe that there are unlikely to be substantial adverse effects associated with this intervention…

In the only trial reporting mild adverse effects, nine out of 18,510 participants reported adverse events, eight of which were mild local skin irritation. None of the other trials reported any serious adverse effects.CHX is broadly regarded as safe to apply to the skin of neonates at standard concentrations (safety at higher concentrations is not known)...

Adverse effects have been noted with respect to the misuse of CHX: specifically, 45 cases of eye injuries in nine African countries resulting from improper application of CHX to the eyes have been reported to WHO as of February 2019. It is unclear what proportion of these injuries were in newborns…

CHX may carry some risk of promoting bacterial resistance. Evidence of bacterial resistance to CHX has been reported, but the extent and clinical significance of this is unclear...

We conducted a preliminary cost-effectiveness analysis and found that CHX may be within the range of cost-effectiveness of the opportunities that we expect to direct marginal donations to as of 2021 (about 10x cash or higher). Cost-effectiveness is driven by baseline neonatal mortality, estimated impacts on neonatal mortality, and low estimated costs.”

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Estimated a 24% base rate among programs GiveWell listed in 2017 but had not given a grant too yet (https://www.givewell.org/research/intervention-reports/august-2017-version)