Poranee Laoitthi Piya Hanvoravongchai

Faculty of Medicine, Chulalongkorn University Bangkok Thailand. 29 Jan 2014

• Social Return On Investment (SROI) Evaluation Concept

• SROI for tobacco control by ThaiHealth

• Results • Discussion and Limitations

What is Social Return on Investment (SROI)?

SROI is “a way of understanding how effectively money is spent.”

• SROI = Value of Benefits Investment

Source: NEF Consulting Group Example: SROI = 10 Every $1 investment equals to social return of $10

SROI & Value for Money Concept have been used: “VfM is defined as the optimum combination of whole-of-life costs and quality (or fitness for purpose) of the good or service to meet the user’s requirement. VfM is not the choice of goods and services based on the lowest cost bid.”

UK HM Treasury (2006) Value for money guidance

The environment

Triple Bottom Line Measurement of values across the ‘triple

bottom line’ The economy People

Source: NEF Consulting Group

SROI Principles 1. Involve Stakeholders 2. Understand what changes 3. Value the things that matter 4. Only include what is material 5. Do not over claim 6. Be transparent 7. Verify the result

Source: NEF Consulting Group

Stages of an SROI analysis

1.  Engage stakeholders to identify outcomes •  Theory of Changes •  inputs > activities > outputs > outcomes

2.  Data collection •  Outcomes •  Impacts: Deadweight, Attribution,

Displacement •  Benefit period and drop off

3.  Model and calculate: Valuation of outcomes 4.  Report

Outcomes Indicators Monetary Value

Outcome incidence (Monetary Unit)

Measuring & Valuing Outcomes

outcome incidence

Minus deadweight incidence

Multiply by attribution

rate Minus

displacement social benefit

Assessing Impacts

what would have happened anyway

value moved from elsewhere

The proportion an organization can

take credit for

ตัวอย่างการประเมินการลงทุนของ สสส. โดยใช้ SROI

SROI of ThaiHealth: Tobacco Control

SROI  evalua+on  using  macro  perspec+ve •  SROI  Assessment  can  be  done  at  the  project  or  aggregate  level.    

•  ThaiHealth  supported  1,000++  projects  •  Several  projects  address  small  specific  acBviBes  that  may  not  be  directly  linked  to  key  outputs/outcomes    

•  Assessing  each  project  may  not  be  appropriate:  – Do  not  cover  the  whole  spectrum  of  desired  outputs/outcomes    

– May  double  count  some  of  the  expected  outputs  

Outcome measurement

•  Household spending on cigarettes and tobacco

•  Economic returns to producers and sellers Economy

Environment

Social and Health

• Health and well being of smokers averted: Avoidable health spending & productivity gained from avoided illnesses

• Family mental health: willingness to pay

• Societal benefit: willingness to pay

Cancelled out

Modeling changes in outcome indicators

•  Use data on Tobacco consumption from National representative surveys done by National Statistics Office (10 x-sectional datasets from 1986- 2009)

•  Estimate cohort specific pattern of smoking prevalence across datasets (sex & year-of-birth cohorts) based on pre-ThaiHealth patterns

•  Estimate smoker prevalence of each cohort if ThaiHealth does not exist

•  Calculate averted smokers from actual vs estimated smokers in each cohort for 2001-2010

Prevalence in Male by age cohorts

Monetary value of averted smokers Physical health = Avoidable health expenditure &

productivity gained = (no. of smokers averted by age-sex)*(estimated health spending and productivity lost for one smoker by age-sex)

Note: value of health spending and productivity lost per smoker from Montarat Thaworncharoensup et al 2011

Valuing Outcomes

Family mental health •  Willingness to pay of family with smokers*

numbers of households with averted smokers

Societal benefit =willingness to pay of general pop to have one fewer smoker

Valuing Outcomes

Physical Health

= 29,257,469,937.0 + (-405,467,511.0)

29 Bil Baht

Family Mental Health

= 3,546.39 baht *268,576 households

952 Mil Baht

Societal benefit

= 898 baht * 324,074

averted smokers

291 Mil Baht

Total 30 Bil Baht

COST ASSESSMENT

Program 10 program program

Public communi

cation

Investments by ThaiHealth

program 1

Program 2

Program 3

Financial support

to program

Office  1

Office 5

Administration cost

Indirect  cost 1.4 Bil baht Program 1.36 Bil baht Direct cost23 mil baht Indirect 43.7 mil baht

Source: HITAP

CALCULATING SROI

Calculation SROI

SROI ratio is 18.3:1. (12.5-19.8)

For the equivalent of 1 baht invested in tobacco control program, 18.3 baht return on social value.

Limitations and suggestion

•  Does not include all results that can not be easily valued e.g. changes in social norms

•  Financial proxies may be difficult to measure e.g. WTP for social benefits

•  There might be biases from the involvement of stakeholders in determining attribution level

•  Activities may effect future preventable smokers; these were not taken into account in this study.

•  Did not consider displacement into other negative behavior e.g. drug use.

•  Equity blinded (no assessment of equity dimension)