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Unit costs, cost - effectiveness, and financing of nutrition interventions

By Susan Horton

Abstract

The author summarizes what is known about unit costs, the cost structure, cost-effectiveness, and financing of eight nutrition interventions: maternal and child health (MCH) feeding, school feeding, nutrition education, the promotion of breastfeeding, targeted food subsidies, micronutrient supplementation, micronutrient fortification, and growth monitoring. Among items that she reports: (1) mass media nutrition education campaigns and the promotion of breastfeeding cost about $1 - $5 per beneficiary; face-to-face nutrition programs cost more ($23 per beneficiary in the Dominican Republic). (2) Food distribution programs of different types have fairly similar costs. For distributing about 1,000 calories aday per beneficiary per year: $75 for untargeted food rations, $64 for targeted food rations, $74 for MCH and school feeding programs, and $134 for highly targeted feeding programs. Micronutrient interventions cost from $0.04 to $4 per person-year of protection; supplementation is more expensive than fortification. (3) Medium-sized feeding programs (100,000 to 500,000 beneficiaries) are the least expensive. There is little difference in cost between programs operated by nongovernement organizations and those operated by governments. The more expensive programs are not necessarily less cost-effective, but may include more complementary inputs. (4) The cost per death averted was about 1,500 for both a targeted supplementary feeding program in Tamil Nadu and a vitamin A capsule distribution scheme in Bangladesh. (5) The cost per child removed from modrate and severe malnutrition ranged from $33 (Tamil Nadu) to $331 (targeted food subsidy, Philippines) to $493 (face-to-face nutrition program, Dominican Republic). (6) Nutrition expenditures seem to account for about 10 percent of health spending, both for donors and for individual countries (Chile is an outlier with 35 percent). Impact data on these topics are scarce, and these estimates should be interpreted cautiously.Nutrition,Health Monitoring&Evaluation,ICT Policy and Strategies,Early Child and Children's Health,School Health

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