Tina G Sanghvi, Rick Homan, Tuan Nguyen, Zeba Mahmud, Tamirat Walissa, Marina Nersesyan, Patricia Preware, Edward A Frongillo, Roger Matheson
{"title":"Incremental financial costs of strengthening large-scale child nutrition programs in Bangladesh, Ethiopia, and Vietnam: retrospective expenditure analysis.","authors":"Tina G Sanghvi, Rick Homan, Tuan Nguyen, Zeba Mahmud, Tamirat Walissa, Marina Nersesyan, Patricia Preware, Edward A Frongillo, Roger Matheson","doi":"10.1186/s12992-025-01118-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Inattention to young child growth and development in a transitioning global environment can undermine the foundation of human capital and future progress. Diets that provide adequate energy and nutrients are critical for children's physical and cognitive development from 6 to 23.9 months of age and beyond. Still, over 70% of young children do not receive foods with sufficient nutrition particularly in low-and-middle income countries. Program evaluations have documented the effectiveness of large-scale behavior change interventions to improve children's diets, but the budgetary implications of programs are not known. This paper provides the incremental financial costs of strengthening three large-scale programs based on expenditure records from Bangladesh, Ethiopia, and Vietnam.</p><p><strong>Results: </strong>The programs reached between one and 2.5 million mothers and children annually per country at unit costs of between $0.9 to $1.6 per mother and child reached. An additional 0.7 to 1.6 million people who were influential in supporting mothers and achieving scale were also engaged. The largest cost component was counselling of mothers. Rigorous external impact evaluations showed that over 434,500 children benefited annually from consuming a minimum acceptable diet in all countries combined, at an annual cost per country of $6.3 to $34.7 per child benefited.</p><p><strong>Conclusions: </strong>Large scale programs to improve young children's nutrition can be affordable for low- and middle-income countries. The study provides the incremental costs of selectively strengthening key program components in diverse settings with lessons for future budgeting. The costs of treating a malnourished child are several-fold higher than prevention through improved improving young children's dietary practices. Differences across countries in program models, coverage, costs, and outcomes suggest that countries need a minimum investment of resources for strengthening high-reach service delivery and communication channels and engaging relevant behavioral levers and community support for mothers to achieve impact at scale.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"21 1","pages":"21"},"PeriodicalIF":5.9000,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013185/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Globalization and Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12992-025-01118-3","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Inattention to young child growth and development in a transitioning global environment can undermine the foundation of human capital and future progress. Diets that provide adequate energy and nutrients are critical for children's physical and cognitive development from 6 to 23.9 months of age and beyond. Still, over 70% of young children do not receive foods with sufficient nutrition particularly in low-and-middle income countries. Program evaluations have documented the effectiveness of large-scale behavior change interventions to improve children's diets, but the budgetary implications of programs are not known. This paper provides the incremental financial costs of strengthening three large-scale programs based on expenditure records from Bangladesh, Ethiopia, and Vietnam.
Results: The programs reached between one and 2.5 million mothers and children annually per country at unit costs of between $0.9 to $1.6 per mother and child reached. An additional 0.7 to 1.6 million people who were influential in supporting mothers and achieving scale were also engaged. The largest cost component was counselling of mothers. Rigorous external impact evaluations showed that over 434,500 children benefited annually from consuming a minimum acceptable diet in all countries combined, at an annual cost per country of $6.3 to $34.7 per child benefited.
Conclusions: Large scale programs to improve young children's nutrition can be affordable for low- and middle-income countries. The study provides the incremental costs of selectively strengthening key program components in diverse settings with lessons for future budgeting. The costs of treating a malnourished child are several-fold higher than prevention through improved improving young children's dietary practices. Differences across countries in program models, coverage, costs, and outcomes suggest that countries need a minimum investment of resources for strengthening high-reach service delivery and communication channels and engaging relevant behavioral levers and community support for mothers to achieve impact at scale.
期刊介绍:
"Globalization and Health" is a pioneering transdisciplinary journal dedicated to situating public health and well-being within the dynamic forces of global development. The journal is committed to publishing high-quality, original research that explores the impact of globalization processes on global public health. This includes examining how globalization influences health systems and the social, economic, commercial, and political determinants of health.
The journal welcomes contributions from various disciplines, including policy, health systems, political economy, international relations, and community perspectives. While single-country studies are accepted, they must emphasize global/globalization mechanisms and their relevance to global-level policy discourse and decision-making.