Managing the vitamin A program portfolio: A case study of Zambia, 2013–2042
Micronutrient deficiencies continue to constitute a major burden of disease, particularly in Africa and South Asia. Programs to address micronutrient deficiencies have been increasing in number, type, and scale in recent years, creating an ever-growing need to understand their combined coverage leve...
| Autores principales: | , |
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| Formato: | Journal Article |
| Lenguaje: | Inglés |
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SAGE Publications
2014
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| Acceso en línea: | https://hdl.handle.net/10568/149809 |
| _version_ | 1855541642852827136 |
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| author | Fiedler, John L. Lividini, Keith |
| author_browse | Fiedler, John L. Lividini, Keith |
| author_facet | Fiedler, John L. Lividini, Keith |
| author_sort | Fiedler, John L. |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Micronutrient deficiencies continue to constitute a major burden of disease, particularly in Africa and South Asia. Programs to address micronutrient deficiencies have been increasing in number, type, and scale in recent years, creating an ever-growing need to understand their combined coverage levels, costs, and impacts so as to more effectively combat deficiencies, avoid putting individuals at risk for excess intakes, and ensure the efficient use of public health resources.To analyze combinations of the two current programs—sugar fortification and Child Health Week (CHW)—together with four prospective programs—vegetable oil fortification, wheat flour fortification, maize meal fortification, and biofortified vitamin A maize—to identify Zambia's optimal vitamin A portfolio.Combining program cost estimates and 30-year Zambian food demand projections, together with the Zambian 2005 Living Conditions Monitoring Survey, the annual costs, coverage, impact, and cost-effectiveness of 62 Zambian portfolios were modeled for the period from 2013 to 2042.Optimal portfolios are identified for each of five alternative criteria: average cost-effectiveness, incremental cost-effectiveness, coverage maximization, health impact maximization, and affordability. The most likely scenario is identified to be one that starts with the current portfolio and takes into account all five criteria. Starting with CHW and sugar fortification, it phases in vitamin A maize, oil, wheat flour, and maize meal (in that order) to eventually include all six individual interventions.Combining cost and Household Consumption and Expenditure Survey (HCES) data provides a powerful evidence-generating tool with which to understand how individual micronutrient programs interact and to quantify the tradeoffs involved in selecting alternative program portfolios. |
| format | Journal Article |
| id | CGSpace149809 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2014 |
| publishDateRange | 2014 |
| publishDateSort | 2014 |
| publisher | SAGE Publications |
| publisherStr | SAGE Publications |
| record_format | dspace |
| spelling | CGSpace1498092024-10-25T08:05:55Z Managing the vitamin A program portfolio: A case study of Zambia, 2013–2042 Fiedler, John L. Lividini, Keith expenditure household consumption and expenditure surveys household surveys nutrition policies retinol trace elements household consumption cost analysis Micronutrient deficiencies continue to constitute a major burden of disease, particularly in Africa and South Asia. Programs to address micronutrient deficiencies have been increasing in number, type, and scale in recent years, creating an ever-growing need to understand their combined coverage levels, costs, and impacts so as to more effectively combat deficiencies, avoid putting individuals at risk for excess intakes, and ensure the efficient use of public health resources.To analyze combinations of the two current programs—sugar fortification and Child Health Week (CHW)—together with four prospective programs—vegetable oil fortification, wheat flour fortification, maize meal fortification, and biofortified vitamin A maize—to identify Zambia's optimal vitamin A portfolio.Combining program cost estimates and 30-year Zambian food demand projections, together with the Zambian 2005 Living Conditions Monitoring Survey, the annual costs, coverage, impact, and cost-effectiveness of 62 Zambian portfolios were modeled for the period from 2013 to 2042.Optimal portfolios are identified for each of five alternative criteria: average cost-effectiveness, incremental cost-effectiveness, coverage maximization, health impact maximization, and affordability. The most likely scenario is identified to be one that starts with the current portfolio and takes into account all five criteria. Starting with CHW and sugar fortification, it phases in vitamin A maize, oil, wheat flour, and maize meal (in that order) to eventually include all six individual interventions.Combining cost and Household Consumption and Expenditure Survey (HCES) data provides a powerful evidence-generating tool with which to understand how individual micronutrient programs interact and to quantify the tradeoffs involved in selecting alternative program portfolios. 2014 2024-08-01T02:49:59Z 2024-08-01T02:49:59Z Journal Article https://hdl.handle.net/10568/149809 en Limited Access SAGE Publications Fiedler, John L.; and Lividini, Keith. 2014. Managing the vitamin A program portfolio: A case study of Zambia, 2013–2042. Food and Nutrition Bulletin 35(1): 105-125. https://doi.org/10.1177/156482651403500112 |
| spellingShingle | expenditure household consumption and expenditure surveys household surveys nutrition policies retinol trace elements household consumption cost analysis Fiedler, John L. Lividini, Keith Managing the vitamin A program portfolio: A case study of Zambia, 2013–2042 |
| title | Managing the vitamin A program portfolio: A case study of Zambia, 2013–2042 |
| title_full | Managing the vitamin A program portfolio: A case study of Zambia, 2013–2042 |
| title_fullStr | Managing the vitamin A program portfolio: A case study of Zambia, 2013–2042 |
| title_full_unstemmed | Managing the vitamin A program portfolio: A case study of Zambia, 2013–2042 |
| title_short | Managing the vitamin A program portfolio: A case study of Zambia, 2013–2042 |
| title_sort | managing the vitamin a program portfolio a case study of zambia 2013 2042 |
| topic | expenditure household consumption and expenditure surveys household surveys nutrition policies retinol trace elements household consumption cost analysis |
| url | https://hdl.handle.net/10568/149809 |
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