The cost and cost-effectiveness of an integrated wasting prevention and screening intervention package in Burkina Faso and Mali
Background Little is known about costs and cost-effectiveness of interventions that integrate wasting prevention into screening for child wasting. Objective This study’s objective was to estimate the cost and cost-effectiveness of an intervention that integrated behavior change communication (BCC)...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Journal Article |
| Language: | Inglés |
| Published: |
Elsevier
2024
|
| Subjects: | |
| Online Access: | https://hdl.handle.net/10568/141522 |
| _version_ | 1855529414194888704 |
|---|---|
| author | Brander, Rebecca L. Puett, Chloe Becquey, Elodie Leroy, Jef L. Ruel, Marie T. Sessou, Fidele Eric Huybregts, Lieven |
| author_browse | Becquey, Elodie Brander, Rebecca L. Huybregts, Lieven Leroy, Jef L. Puett, Chloe Ruel, Marie T. Sessou, Fidele Eric |
| author_facet | Brander, Rebecca L. Puett, Chloe Becquey, Elodie Leroy, Jef L. Ruel, Marie T. Sessou, Fidele Eric Huybregts, Lieven |
| author_sort | Brander, Rebecca L. |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Background
Little is known about costs and cost-effectiveness of interventions that integrate wasting prevention into screening for child wasting.
Objective
This study’s objective was to estimate the cost and cost-effectiveness of an intervention that integrated behavior change communication (BCC) and small-quantity lipid-based nutrient supplements (SQ-LNS) into platforms for wasting screening in Burkina Faso (a facility-based platform, where BCC was enhanced compared to standard care) and Mali (a community-based platform, with standard BCC).
Methods
Activity-based costing was used to estimate the cost per child-contact for the intervention and the comparison group, which did not receive the intervention. Costs were ascertained from accounting records, interviews, surveys, and observations. The number of child-contacts were calculated using population size estimates and average attendance rates for each service. Costs per disability-adjusted life year (DALY) averted were estimated using a Markov model populated with data from the parent trials on impact on wasting incidence and treatment coverage.
Results
In the intervention group in Burkina Faso, the cost per child-contact of facility-based screening was $0.85, of enhanced BCC was $4.28, and of SQ-LNS was $8.86. In Mali, the cost per child-contact of community-based screening was $0.57, of standard BCC was $0.72, and of SQ-LNS was $4.14. Although no SQ-LNS costs were incurred in the comparison groups (hence lower total costs), costs per child-contact for screening and BCC were higher because coverage of these services was lower. The intervention package cost $1,073 per DALY averted in Burkina Faso and $747 in Mali.
Conclusions
Integration of wasting prevention into screening for child wasting led to higher total costs but lower unit costs than standard screening due to increased coverage. Greater cost-effectiveness could be achieved if BCC were strengthened and led to improved caregiver health and nutrition practices and if screening triggered appropriate use of services and higher treatment coverage. |
| format | Journal Article |
| id | CGSpace141522 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2024 |
| publishDateRange | 2024 |
| publishDateSort | 2024 |
| publisher | Elsevier |
| publisherStr | Elsevier |
| record_format | dspace |
| spelling | CGSpace1415222025-04-08T18:26:31Z The cost and cost-effectiveness of an integrated wasting prevention and screening intervention package in Burkina Faso and Mali Brander, Rebecca L. Puett, Chloe Becquey, Elodie Leroy, Jef L. Ruel, Marie T. Sessou, Fidele Eric Huybregts, Lieven malnutrition wasting disease (nutritional disorder) economic value cost analysis screening supplementary feeding lipids Background Little is known about costs and cost-effectiveness of interventions that integrate wasting prevention into screening for child wasting. Objective This study’s objective was to estimate the cost and cost-effectiveness of an intervention that integrated behavior change communication (BCC) and small-quantity lipid-based nutrient supplements (SQ-LNS) into platforms for wasting screening in Burkina Faso (a facility-based platform, where BCC was enhanced compared to standard care) and Mali (a community-based platform, with standard BCC). Methods Activity-based costing was used to estimate the cost per child-contact for the intervention and the comparison group, which did not receive the intervention. Costs were ascertained from accounting records, interviews, surveys, and observations. The number of child-contacts were calculated using population size estimates and average attendance rates for each service. Costs per disability-adjusted life year (DALY) averted were estimated using a Markov model populated with data from the parent trials on impact on wasting incidence and treatment coverage. Results In the intervention group in Burkina Faso, the cost per child-contact of facility-based screening was $0.85, of enhanced BCC was $4.28, and of SQ-LNS was $8.86. In Mali, the cost per child-contact of community-based screening was $0.57, of standard BCC was $0.72, and of SQ-LNS was $4.14. Although no SQ-LNS costs were incurred in the comparison groups (hence lower total costs), costs per child-contact for screening and BCC were higher because coverage of these services was lower. The intervention package cost $1,073 per DALY averted in Burkina Faso and $747 in Mali. Conclusions Integration of wasting prevention into screening for child wasting led to higher total costs but lower unit costs than standard screening due to increased coverage. Greater cost-effectiveness could be achieved if BCC were strengthened and led to improved caregiver health and nutrition practices and if screening triggered appropriate use of services and higher treatment coverage. 2024-08 2024-04-18T15:43:26Z 2024-04-18T15:43:26Z Journal Article https://hdl.handle.net/10568/141522 en https://doi.org/10.1016/j.cdnut.2024.102929 Open Access Elsevier Brander, Rebecca L.; Puett, Chloe; Becquey, Elodie; Leroy, Jef L.; Ruel, Marie T.; Sessou, Fidele Eric; and Huybregts, Lieven. 2024. The cost and cost-effectiveness of an integrated wasting prevention and screening intervention package in Burkina Faso and Mali. Journal of Nutrition 154(8): 2551-2565. https://doi.org/10.1016/j.tjnut.2024.04.010 |
| spellingShingle | malnutrition wasting disease (nutritional disorder) economic value cost analysis screening supplementary feeding lipids Brander, Rebecca L. Puett, Chloe Becquey, Elodie Leroy, Jef L. Ruel, Marie T. Sessou, Fidele Eric Huybregts, Lieven The cost and cost-effectiveness of an integrated wasting prevention and screening intervention package in Burkina Faso and Mali |
| title | The cost and cost-effectiveness of an integrated wasting prevention and screening intervention package in Burkina Faso and Mali |
| title_full | The cost and cost-effectiveness of an integrated wasting prevention and screening intervention package in Burkina Faso and Mali |
| title_fullStr | The cost and cost-effectiveness of an integrated wasting prevention and screening intervention package in Burkina Faso and Mali |
| title_full_unstemmed | The cost and cost-effectiveness of an integrated wasting prevention and screening intervention package in Burkina Faso and Mali |
| title_short | The cost and cost-effectiveness of an integrated wasting prevention and screening intervention package in Burkina Faso and Mali |
| title_sort | cost and cost effectiveness of an integrated wasting prevention and screening intervention package in burkina faso and mali |
| topic | malnutrition wasting disease (nutritional disorder) economic value cost analysis screening supplementary feeding lipids |
| url | https://hdl.handle.net/10568/141522 |
| work_keys_str_mv | AT branderrebeccal thecostandcosteffectivenessofanintegratedwastingpreventionandscreeninginterventionpackageinburkinafasoandmali AT puettchloe thecostandcosteffectivenessofanintegratedwastingpreventionandscreeninginterventionpackageinburkinafasoandmali AT becqueyelodie thecostandcosteffectivenessofanintegratedwastingpreventionandscreeninginterventionpackageinburkinafasoandmali AT leroyjefl thecostandcosteffectivenessofanintegratedwastingpreventionandscreeninginterventionpackageinburkinafasoandmali AT ruelmariet thecostandcosteffectivenessofanintegratedwastingpreventionandscreeninginterventionpackageinburkinafasoandmali AT sessoufideleeric thecostandcosteffectivenessofanintegratedwastingpreventionandscreeninginterventionpackageinburkinafasoandmali AT huybregtslieven thecostandcosteffectivenessofanintegratedwastingpreventionandscreeninginterventionpackageinburkinafasoandmali AT branderrebeccal costandcosteffectivenessofanintegratedwastingpreventionandscreeninginterventionpackageinburkinafasoandmali AT puettchloe costandcosteffectivenessofanintegratedwastingpreventionandscreeninginterventionpackageinburkinafasoandmali AT becqueyelodie costandcosteffectivenessofanintegratedwastingpreventionandscreeninginterventionpackageinburkinafasoandmali AT leroyjefl costandcosteffectivenessofanintegratedwastingpreventionandscreeninginterventionpackageinburkinafasoandmali AT ruelmariet costandcosteffectivenessofanintegratedwastingpreventionandscreeninginterventionpackageinburkinafasoandmali AT sessoufideleeric costandcosteffectivenessofanintegratedwastingpreventionandscreeninginterventionpackageinburkinafasoandmali AT huybregtslieven costandcosteffectivenessofanintegratedwastingpreventionandscreeninginterventionpackageinburkinafasoandmali |