Incremental financial costs of strengthening large-scale child nutrition programs in Bangladesh, Ethiopia, and Vietnam: retrospective expenditure analysis.

IF 5.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Tina G Sanghvi, Rick Homan, Tuan Nguyen, Zeba Mahmud, Tamirat Walissa, Marina Nersesyan, Patricia Preware, Edward A Frongillo, Roger Matheson
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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.

孟加拉国、埃塞俄比亚和越南加强大规模儿童营养项目的增量财政成本:回顾性支出分析。
背景:在转型的全球环境中,忽视幼儿的成长和发展可能会破坏人力资本的基础和未来的进步。提供充足能量和营养的饮食对6至23.9个月及以上儿童的身体和认知发育至关重要。然而,超过70%的幼儿得不到足够营养的食物,特别是在低收入和中等收入国家。项目评估记录了大规模行为改变干预措施改善儿童饮食的有效性,但项目的预算影响尚不清楚。本文以孟加拉国、埃塞俄比亚和越南的支出记录为基础,提供了加强三个大型项目的增量财政成本。结果:这些项目每年惠及每个国家100万至250万名母亲和儿童,每名母亲和儿童的单位成本在0.9美元至1.6美元之间。另外有70万至160万在支持母亲和实现规模方面有影响力的人也参与其中。最大的费用是对母亲的咨询。严格的外部影响评价表明,在所有国家,每年有443 500多名儿童受益于食用最低限度的可接受饮食,每个国家每年为每个受益儿童花费6.3至34.7美元。结论:低收入和中等收入国家可以负担得起改善幼儿营养的大规模项目。该研究提供了在不同情况下选择性地加强关键方案组成部分的增量成本,并为今后的预算编制提供了经验教训。治疗营养不良儿童的费用比通过改善幼儿饮食习惯进行预防的费用高出数倍。各国在规划模式、覆盖面、成本和成果方面的差异表明,各国需要投入最少的资源,以加强高覆盖范围的服务提供和沟通渠道,并为母亲提供相关的行为杠杆和社区支持,以实现大规模影响。
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来源期刊
Globalization and Health
Globalization and Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
18.40
自引率
1.90%
发文量
93
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.
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