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Cost-effectiveness of a market-based home fortification of food with micronutrient powder programme in Bangladesh

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dc.contributor.authorAhmed, Sayem
dc.contributor.authorSarma, Haribondhu
dc.contributor.authorHasan, Md Zahid
dc.contributor.authorRahman, Mahfuzur
dc.contributor.authorAhmed, Mohammad Wahid
dc.contributor.authorIslam, Mohammad Ashraful
dc.contributor.authorDjimeu, Eric W
dc.contributor.authorMbuya, Mduduzi NN
dc.contributor.authorAhmed, Tahmeed
dc.contributor.authorKhan, Jahangir AM
dc.date.accessioned2022-10-17T03:09:20Z
dc.date.available2022-10-17T03:09:20Z
dc.date.issued2020
dc.date.updated2021-11-28T07:23:32Z
dc.description.abstractObjective: We estimated the cost-effectiveness of home fortification with micronutrient powder delivered in a sales-based programme in reducing the prevalence of Fe deficiency anaemia among children 6–59 months in Bangladesh. Design: Cross-sectional interviews with local and central-level programme staff and document reviews were conducted. Using an activity-based costing approach, we estimated start-up and implementation costs of the programme. The incremental cost per anaemia case averted and disability-adjusted life years (DALY) averted were estimated by comparing the home fortification programme and no intervention scenarios. Setting: The home fortification programme was implemented in 164 upazilas (sub-districts) in Bangladesh. Participants: Caregivers of child 6–59 months and BRAC staff members including community health workers were the participants for this study. Results: The home fortification programme had an estimated total start-up cost of 35·46 million BDT (456 thousand USD) and implementation cost of 1111·63 million BDT (14·12 million USD). The incremental cost per Fe deficiency anaemia case averted and per DALY averted was estimated to be 1749 BDT (22·2 USD) and 12 558 BDT (159·3 USD), respectively. Considering per capita gross domestic product (1516·5 USD) as the cost-effectiveness threshold, the home fortification programme was highly cost-effective. The programme coverage and costs for nutritional counselling of the beneficiary were influential parameters for cost per DALY averted in the one-way sensitivity analysis. Conclusions: The market-based home fortification programme was a highly cost-effective mechanism for delivering micronutrients to a large number of children in Bangladesh. The policymakers should consider funding and sustaining large-scale sales-based micronutrient home fortification efforts assuming the clear population-level need and potential to benefit persists.en_AU
dc.format.mimetypeapplication/pdfen_AU
dc.identifier.issn1368-9800en_AU
dc.identifier.urihttp://hdl.handle.net/1885/275554
dc.language.isoen_AUen_AU
dc.provenanceThis is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly citeden_AU
dc.publisherCABI Publishingen_AU
dc.rights© 2019 The authorsen_AU
dc.rights.licenseCreative Commons Attribution licenceen_AU
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_AU
dc.sourcePublic Health Nutritionen_AU
dc.subjectActivity-based cost analysisen_AU
dc.subjectCost-effectiveness analysisen_AU
dc.subjectDisability-adjusted life yearsen_AU
dc.subjectHome fortificationen_AU
dc.subjectMicronutrienten_AU
dc.subjectFe deficiency anaemiaen_AU
dc.subjectBangladeshen_AU
dc.titleCost-effectiveness of a market-based home fortification of food with micronutrient powder programme in Bangladeshen_AU
dc.typeJournal articleen_AU
dcterms.accessRightsOpen Accessen_AU
local.bibliographicCitation.lastpage70en_AU
local.bibliographicCitation.startpage59en_AU
local.contributor.affiliationAhmed, Sayem, Health Systems and Population Studies Divisionen_AU
local.contributor.affiliationSarma, Haribondhu, College of Health and Medicine, ANUen_AU
local.contributor.affiliationHasan, Md Zahid, Health Systems and Population Studies Divisionen_AU
local.contributor.affiliationRahman, Mahfuzur, Nutrition and Clinical Services Divisionen_AU
local.contributor.affiliationAhmed, Mohammad Wahid, Health Systems and Population Studies Divisionen_AU
local.contributor.affiliationIslam, Mohammad Ashraful, Nutrition and Clinical Services Divisionen_AU
local.contributor.affiliationDjimeu, Eric W, Global Alliance for Improve Nutritionen_AU
local.contributor.affiliationMbuya, Mduduzi NN , Global Alliance for Improved Nutritionen_AU
local.contributor.affiliationAhmed, Tahmeed, Nutrition and Clinical Services Divisionen_AU
local.contributor.affiliationKhan, Jahangir AM, Karolinska Instituteten_AU
local.contributor.authoruidSarma, Haribondhu, u5930488en_AU
local.description.notesImported from ARIESen_AU
local.identifier.absfor420399 - Health services and systems not elsewhere classifieden_AU
local.identifier.absfor420601 - Community child healthen_AU
local.identifier.absseo200205 - Health policy evaluationen_AU
local.identifier.ariespublicationa383154xPUB16790en_AU
local.identifier.citationvolume24en_AU
local.identifier.doi10.1017/S1368980020003602en_AU
local.identifier.scopusID2-s2.0-85095424482
local.publisher.urlhttps://www.cambridge.org/en_AU
local.type.statusPublished Versionen_AU

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