Benefit-cost analysis in the nutrition area: A project in the Philippines

A benefit-cost analysis framework was developed to compare the relative effectiveness ofthree programs designed to eliminate severe vitamin A deficiency. Each program was run in four ecological areas over a 2-year period. Program benefits in terms of reduced mortality, blindness, morbidity and treatment costs, the effectiveness of each program against each type of benefit, and direct and indirect program costs were calculated. The three programs were the distribution twice yearly of a mass dosage vitamin A capsule, vitamin A fortification of monosodium glutamate (MSG), and a public health intervention which used paraprofessionals for an education, sanitation, immunization, and horticulture program. Benefits and costs accruing to children were compared and the resulting benefit-cost ratios showed that the fortification and mass dosage capsule programs had social benefits much greater than their costs. As a result, MSG fortification is being tested in a three-province area in the Philippines and is being considered for national implementation.