{ "version": "0.1", "id": "friendship-bench-zimbabwe", "name": "Depression relief with Friendship Bench Zimbabwe", "checkedOn": "2026-10-12", "checkedTimezone": "UTC", "evidenceStatus": "exploratory", "costBasis": "USD received for Friendship Bench Zimbabwe work, provisionally mapped to future care using a broad allowance per client. Not a verified marginal cost, an earmarked treatment purchase or an estimate for the global organization.", "sourceFacts": { "trialYearPublished": 2016, "trialRandomizedParticipants": 573, "trialClinics": 24, "depressionThresholdControl": 0.499, "depressionThresholdIntervention": 0.137, "thresholdMeaning": "PHQ-9 at least 11 at six months; secondary screening outcome in adults initially screening positive for common mental disorders. Not a confirmed diagnosis or direct suffering measurement.", "fixedAnnualCostUSD": 170419, "variableCostPerClientUSD": 3.37, "annualClients2020": 12364, "costPriceYear": 2019, "costPerspective": "Historical payer cost across program and city health resources; annualized scale-up, infrastructure, screening and treatment. Includes modeled and anticipated inputs.", "laterRuralTrialParticipants": 516, "laterRuralTrialFinding": "Greater SSQ-14 improvement at months 3, 6 and 9, but not 12; no difference in PHQ-9 score changes at measured follow-ups.", "annual2025MonitoringEnrolled": 13864, "annual2025MonitoringCompleteClinicalData": 3009, "annual2025MonitoringHasConcurrentControl": false, "reportedClientsQ12026": 88436 }, "sharedAssumptions": { "referenceIntensityHours": 47.25, "intensityExponent": 1, "creditedDays": 90, "creditedWindow": "Assumed days 91 through 180 after starting care. A six-month endpoint does not establish 90 days of continuous relief. Earlier and later benefits are unestimated.", "endpointProxyBasis": "Treat the scaled between-group difference in depression-screening status as additional improved-outcome equivalents. This is a WSI bridge to a relief scenario, not an observed count of durable recoveries or a validated USU mapping.", "deliveryBasis": "Share of spending assumed to translate into additional adult care resembling the reference population. Combines age and setting eligibility, allocation and whether care would happen anyway. Not a measured program share.", "effectBasis": "Retain only a selected fraction of the old urban trial difference to allow for fewer sessions, changed delivery and mixed evidence across settings. This factor is distinct from whether a donation brings additional eligible care.", "intensityBasis": "One average reduction in psychological suffering across the credited hours, including sleep and periods of relief. WSI judgment; no conversion from PHQ-9, SSQ-14, DALYs or WELLBYs." }, "scenarios": { "lower": { "label": "No added effect", "costPerClientUSD": 50, "additionalEligibleCareShare": 0.5, "trialEffectRetained": 0, "averageIntensityReduction": 1 }, "central": { "label": "Central", "costPerClientUSD": 50, "additionalEligibleCareShare": 0.5, "trialEffectRetained": 0.5, "averageIntensityReduction": 1 }, "higher": { "label": "Higher", "costPerClientUSD": 25, "additionalEligibleCareShare": 0.75, "trialEffectRetained": 0.75, "averageIntensityReduction": 2 } }, "fundingSnapshot": { "status": "donation_page_available_gap_unverified", "checkedOn": "2026-10-12", "remainingFundingGapUSD": null, "verifiedMarginalCostUSD": null, "confirmedAllocation": null, "basis": "Official Zimbabwe donation page and Q1 2026 activity report. Public activity and solicitation do not establish current unmet budget, next allocation or additional treatments.", "recheckDue": "2026-11-11" }, "donationURL": "https://www.friendshipbenchzimbabwe.org/donate", "sources": [ { "id": "B1", "title": "Chibanda et al. (2016): randomized trial in Harare", "url": "https://pubmed.ncbi.nlm.nih.gov/28027368/", "doi": "10.1001/jama.2016.19102", "locator": "Abstract: six-month PHQ-9 threshold proportions, 13.7% versus 49.9%", "role": "Historical trial reference; reported absolute proportions, not an adjusted absolute effect", "checkedOn": "2026-10-12" }, { "id": "B2", "title": "Healey et al. (2022): economic analysis of Friendship Bench scale-up", "url": "https://doi.org/10.1136/ebmental-2021-300317", "publicCopyURL": "https://prevention-collaborative.org/wp-content/uploads/2024/05/Economic-threshold-analysis-of-delivering-a-tasksharing-treatment-for-common-mental-disorders.pdf", "locator": "Table 2, printed page 51; payer perspective and 2019 USD in methods", "role": "Historical cost context, not a current marginal donation price", "checkedOn": "2026-10-12" }, { "id": "B3", "title": "Haas et al. (2023): randomized trial in rural Zimbabwe", "url": "https://pubmed.ncbi.nlm.nih.gov/37440230/", "doi": "10.1001/jamanetworkopen.2023.23205", "locator": "Abstract: SSQ-14 and PHQ-9 results at 3, 6, 9 and 12 months", "role": "Evidence that results differ across populations and outcomes", "checkedOn": "2026-10-12" }, { "id": "B4", "title": "Friendship Bench Zimbabwe: 2025 annual report", "url": "https://drive.google.com/file/d/1jcoxqvNNTnkIsByD-dSK-u0gnaQzUYCQ/view", "locator": "Printed pages 12-13: follow-up cohort and limitations; not the current USU effect input", "role": "Recent monitoring, with incomplete follow-up and no concurrent comparison group", "checkedOn": "2026-10-12" }, { "id": "B5", "title": "Friendship Bench Zimbabwe: Q1 2026 impact report", "url": "https://drive.google.com/file/d/1LzxwolHr_aaM9F7-X-uzb20bYUlmi4jJ/view", "locator": "Printed page 9: clients seen; page 17: funding invitation", "role": "Current operations and request for support, not verified remaining need", "checkedOn": "2026-10-12" }, { "id": "B6", "title": "Friendship Bench Zimbabwe: evolution of the program", "url": "https://www.friendshipbenchzimbabwe.org/post/the-evolution-of-friendship-bench-two-decades-of-community-led-mental-health-care-in-zimbabwe", "role": "Transition toward government delivery and technical assistance; broader populations", "checkedOn": "2026-10-12" }, { "id": "B7", "title": "Happier Lives Institute (2025): mid-year charity update", "url": "https://www.happierlivesinstitute.org/report/2025-mid-year-charities-update-hlis-first-mid-year-charities-update-and-how-were-changing-the-way-we-keep-donors-informed/", "locator": "Friendship Bench section: historical routine attendance averaging 1.12 of 6 possible sessions", "role": "Evaluator's original implementation analysis; not assumed to measure 2026 attendance", "checkedOn": "2026-10-12" } ], "interpretation": "Exploratory gross psychological relief over an assumed 90 days. Costs, additional delivery, transfer of trial results, duration and intensity are WSI choices. A screening threshold is not a direct suffering measure. Scenarios are not confidence bounds or a ranking. Actual additional benefit can be zero; treatment harms and deaths prevented are unestimated. General donation allocation to matching Zimbabwe adult care is not verified.", "exclusions": [ "benefits in the first 90 days or after day 180", "adolescent and non-Zimbabwe benefits", "benefits outside the selected depression-screening proxy", "treatment harms", "suicides or other deaths prevented", "physical illness outcomes", "caregiver and income effects", "bereavement add-ons" ], "calculation": { "modelVersion": "0.1", "checkedOn": "2026-10-12", "budgetUSD": 1000, "costBasis": "USD received for Friendship Bench Zimbabwe work, provisionally mapped to future care using a broad allowance per client. Not a verified marginal cost, an earmarked treatment purchase or an estimate for the global organization.", "referenceAbsoluteDifference": 0.362, "historicalPayerCostPerClientUSD": 17.15348430928502, "sharedAssumptions": { "referenceIntensityHours": 47.25, "intensityExponent": 1, "creditedDays": 90, "creditedWindow": "Assumed days 91 through 180 after starting care. A six-month endpoint does not establish 90 days of continuous relief. Earlier and later benefits are unestimated.", "endpointProxyBasis": "Treat the scaled between-group difference in depression-screening status as additional improved-outcome equivalents. This is a WSI bridge to a relief scenario, not an observed count of durable recoveries or a validated USU mapping.", "deliveryBasis": "Share of spending assumed to translate into additional adult care resembling the reference population. Combines age and setting eligibility, allocation and whether care would happen anyway. Not a measured program share.", "effectBasis": "Retain only a selected fraction of the old urban trial difference to allow for fewer sessions, changed delivery and mixed evidence across settings. This factor is distinct from whether a donation brings additional eligible care.", "intensityBasis": "One average reduction in psychological suffering across the credited hours, including sleep and periods of relief. WSI judgment; no conversion from PHQ-9, SSQ-14, DALYs or WELLBYs." }, "scenarios": { "lower": { "label": "No added effect", "costPerClientUSD": 50, "additionalEligibleCareShare": 0.5, "trialEffectRetained": 0, "averageIntensityReduction": 1, "supportedClientEquivalents": 20.0, "additionalEligibleClients": 10.0, "additionalImprovedOutcomes": 0.0, "reliefDays": 0.0, "usuAverted": 0.0, "directDeathsPrevented": null }, "central": { "label": "Central", "costPerClientUSD": 50, "additionalEligibleCareShare": 0.5, "trialEffectRetained": 0.5, "averageIntensityReduction": 1, "supportedClientEquivalents": 20.0, "additionalEligibleClients": 10.0, "additionalImprovedOutcomes": 1.81, "reliefDays": 162.9, "usuAverted": 82.74285714285715, "directDeathsPrevented": null }, "higher": { "label": "Higher", "costPerClientUSD": 25, "additionalEligibleCareShare": 0.75, "trialEffectRetained": 0.75, "averageIntensityReduction": 2, "supportedClientEquivalents": 40.0, "additionalEligibleClients": 30.0, "additionalImprovedOutcomes": 8.145, "reliefDays": 733.05, "usuAverted": 744.6857142857142, "directDeathsPrevented": null } }, "interpretation": "Exploratory gross psychological relief over an assumed 90 days. Costs, additional delivery, transfer of trial results, duration and intensity are WSI choices. A screening threshold is not a direct suffering measure. Scenarios are not confidence bounds or a ranking. Actual additional benefit can be zero; treatment harms and deaths prevented are unestimated. General donation allocation to matching Zimbabwe adult care is not verified." } }