Comparing costs and cost‐efficiency of platforms for micronutrient powder (MNP) delivery to children in rural Uganda
| Autor: | Emily Baker, Sorrel Namaste, Stephen A. Vosti, Alexis D'Agostino, Belinda Richardson, Whitney Schott |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Rural Population Opportunity cost costing Cost effectiveness Total cost Cost-Benefit Analysis Nyasnutr1013 Child Nutrition Disorders General Biochemistry Genetics and Molecular Biology 03 medical and health sciences 0302 clinical medicine History and Philosophy of Science infant and young child feeding 030225 pediatrics Environmental health Nyasphys1560 Humans Public Health Surveillance Uganda 030212 general & internal medicine Micronutrients Activity-based costing development cost‐efficiency micronutrient powders Cost efficiency General Neuroscience Infant Rural district Original Articles cost‐effectiveness Micronutrient Nutrition Surveys anemia Nyaspubl8657 Child Preschool Dietary Supplements Original Article Female Business Powders Nyasbiol3577 District level delivery platforms |
| Zdroj: | Annals of the New York Academy of Sciences |
| ISSN: | 1749-6632 0077-8923 |
| Popis: | Micronutrient powder (MNP) can reduce iron deficiency in young children, which has been well established in efficacy trials. However, the cost of different delivery platforms has not been determined. We calculated the cost and cost‐efficiency of distributed MNP through community‐based mechanisms and in health facilities in a primarily rural district in Uganda. An endline survey (n = 1072) identified reach and adherence. During the 9‐month pilot, 37,458 (community platform) and 12,390 (facility platform) packets of MNP were distributed. Each packet consisted of 30 MNP sachets. In 2016, total costs were $277,082 (community platform, $0.24/sachet) and $221,568 (facility platform, $0.59/sachet). The cost per child reached was lower in the community platform ($53.24) than the facility platform ($65.97). The cost per child adhering to a protocol was $58.08 (community platform) and $72.69 (facility platform). The estimated cost of scaling up the community platform pilot to the district level over 3 years to cover approximately 17,890 children was $1.23 million (scale‐up integrated into a partner agency program) to $1.62 million (government scale‐up scenario). Unlike previous estimates, these included opportunity costs. Community‐based MNP delivery costs were greater, yet more cost‐efficient per child reached and adhering to protocol than facility‐based delivery. However, total costs for untargeted MNP delivery under program settings are potentially prohibitive. This study estimates costs based on programmatic elements using two delivery platforms in a single rural site in Uganda: (1) delivery by community health workers (community‐based platform) and (2) delivery using facility‐based health providers (facility‐based platform). We calculated the cost of micronutrient powders (MNP) provision from start‐up to the “last mile”— the final leg in product and service delivery when MNP reaches beneficiaries. We compared costs and cost‐efficiency across delivery platforms using several indicators of outcomes and estimated the costs of scaling up, extending the pilot program, and integrating MNP delivery activities into existing infant and young child feeding programs. |
| Databáze: | OpenAIRE |
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