Maternal & Child Nutrition最新文献

筛选

英文中文

The costs of Suaahara II, a complex scaled-up multisectoral nutrition programme in Nepal 尼泊尔复杂的多部门营养计划 Suaahara II 的费用

Maternal & Child Nutrition Pub Date : 2024-05-05 DOI: 10.1111/mcn.13658

Esther M. Choo, Christopher G. Kemp, K. C. Sagun, Uttam Paudel, Jolene Wun, Kenda Cunningham, Pushpa Acharya, Pooja Pandey Rana, Carol Levin

{"title":"The costs of Suaahara II, a complex scaled-up multisectoral nutrition programme in Nepal","authors":"Esther M. Choo, Christopher G. Kemp, K. C. Sagun, Uttam Paudel, Jolene Wun, Kenda Cunningham, Pushpa Acharya, Pooja Pandey Rana, Carol Levin","doi":"10.1111/mcn.13658","DOIUrl":"https://doi.org/10.1111/mcn.13658","url":null,"abstract":"Limited evidence exists on the costs of scaled-up multisectoral nutrition programmes. Such evidence is crucial to assess intervention value and affordability. Evidence is also lacking on the opportunity costs of implementers and participants engaging in community-level interventions. We help to fill this gap by estimating the full financial and economic costs of the United States Agency for International Development-funded Suaahara II (SII) programme, a scaled-up multisectoral nutrition programme in Nepal (2016–2023). We applied a standardized mixed methods costing approach to estimate total and unit costs over a 3.7-year implementation period. Financial expenditure data from national and subnational levels were combined with economic cost estimates assessed using in-depth interviews and focus group discussions with staff, volunteers, community members, and government partners in four representative districts. The average annual total cost was US$908,948 per district, with economic costs accounting for 47% of the costs. The annual unit cost was US$132 per programme participant (mother in the 1000-day period between conception and a child's second birthday) reached. Annual costs ranged from US$152 (mountains) to US$118 (plains) per programme participant. Personnel (63%) were the largest input cost driver, followed by supplies (11%). Community events (29%) and household counselling visits (17%) were the largest activity cost drivers. Volunteer cadres contributed significant time to the programme, with female community health volunteers spending a substantial amount of time (27 h per month) on SII activities. Multisectoral nutrition programmes can be costly, especially when taking into consideration volunteer and participant opportunity costs. This study provides much-needed evidence of the costs of scaled-up multisectoral nutrition programmes for future comparison against benefits.","PeriodicalId":501646,"journal":{"name":"Maternal & Child Nutrition","volume":"104 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140838933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A qualitative study of Suaahara II influence on nutrition governance in Nepal 关于 Suaahara II 对尼泊尔营养治理影响的定性研究

Maternal & Child Nutrition Pub Date : 2024-05-03 DOI: 10.1111/mcn.13659

Sarah Eissler, Shraddha Manandhar, Kabita Shah, Bishow Neupane, Pooja Pandey Rana, Kristine Garn

{"title":"A qualitative study of Suaahara II influence on nutrition governance in Nepal","authors":"Sarah Eissler, Shraddha Manandhar, Kabita Shah, Bishow Neupane, Pooja Pandey Rana, Kristine Garn","doi":"10.1111/mcn.13659","DOIUrl":"https://doi.org/10.1111/mcn.13659","url":null,"abstract":"Maternal and child undernutrition remain major public health problems in Nepal. Suaahara is a USAID-funded multi-sectoral nutrition programme aiming to strengthen local nutrition governance to reduce maternal and child undernutrition, among other objectives. The purpose of this study is to present findings from a recent qualitative evaluation of Suaahara II's influence on the decentralised implementation of Nepal's Multi-sectoral Nutrition Plan (MSNP) and identifying gaps and areas for improvement at the federal, provincial, and local levels to strengthen nutrition governance. This study employed multiple qualitative methods, engaging over 100 multi-sectoral nutrition stakeholders across three levels of government and eight districts. Thematic qualitative analysis was employed to identify emergent and salient themes, which were triangulated with other secondary data sources. Suaahara II had a positive influence on strengthening horizontal coordination for implementing the MSNP and effectively leveraged existing networks to strengthen implementation of nutrition-focused activities at the municipal level. Although there was an observable increased demand for nutrition budgets attributable to Suaahara II activities, sufficient allocation and utilisation, particularly in non-health sectors, did not meet these levels. Nepal's shift to federalism hindered vertical coordination of MSNP implementation. Some formal coordination mechanisms were strengthened, but variation in their effectiveness to strengthen horizontal and vertical coordination to implement MSNP activities continues. Finally, limited government ownership over nutrition activities and facilitating multi-sector coordination to implement the MSNP threatened sustainability of Suaahara II's outcomes on nutrition governance. Future programmes should continue to build on the progress made under Suaahara II, and specifically aim to address challenges in vertical coordination to strengthen nutrition governance in Nepal.","PeriodicalId":501646,"journal":{"name":"Maternal & Child Nutrition","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140838751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0