Determinants, Impact and Optimal Resource Allocation of Zambia's Scaling Up Nutrition Program.

Abstract

Objectives: Zambia's Scaling Up Nutrition (SUN) Program is a multi-sectoral program with a package of nutrition-specific and nutrition-sensitive interventions to reduce stunting in children. The purpose of the study was to conduct an economic analysis of the SUN Most Critical Days Program (MCDP) II activities during 2018-2022.

Methods: The economic analysis evaluated SUN/MCDP II nutrition interventions through three analyses: (i) estimating their impact on mortality and morbidity since 2018 with the LiST tool, (ii) identifying the determinants of stunting with a Oaxaca Blinder counterfactual decomposition, and (iii) assessing the efficient resource allocation of SUN/MCDP II resources using the Optima Nutrition Tool.

Results: The LiST modelling analysis estimated that since 2018, SUN/MCDP II interventions reduced deaths, diarrhoeal incidence, and stunting among children under 5 years of age in all 30 districts. Vitamin A supplementation was the largest contributor to reductions in deaths and diarrhoeal incidence, The Oaxaca Blinder counterfactual decomposition analysis found that the main contributors to stunting decline were access to piped water, maternal education, child birth weight, and basic sanitation in Zambia. The Optima Nutrition analysis revealed that stunting decline could be maximized if more funding is put into the interventions of Vitamin A and WASH interventions as well as adding some other interventions.

Conclusion for practice: The SUN Program has led to a reduction in childhood stunting as well as mortality. The Program's package of interventions could be further enhanced through optimizing the allocation of resources.