Societal Costs of Micronutrient Deficiencies in 6- to 59-month-old Children in Pakistan
Simon Wieser1, Beatrice Brunner1, Christina Tzogiou1
11 Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland.
Insights
Micronutrient deficiencies in Pakistani children cost billions in lost income and health impacts. Improving nutrition can eliminate these costs and boost national development.
Area of Science:
- Public Health
- Health Economics
- Nutrition Science
Background:
- Nearly half of Pakistani children under 5 are stunted, with widespread micronutrient deficiencies.
- Undernutrition, including deficiencies in essential vitamins and minerals, increases illness, death, and developmental issues.
- These deficiencies pose a significant, yet often overlooked, public health challenge.
Purpose of the Study:
- To quantify the lifetime economic and health burden of micronutrient deficiencies in Pakistani children aged 6-59 months.
- To estimate the societal costs associated with deficiencies in iodine, iron, vitamin A, and zinc.
- To inform policy and interventions for early childhood nutrition.
Main Methods:
- A health economic model was developed to assess long-term consequences.
- Data from population surveys, clinical trials, and other sources were utilized.
- Costs were evaluated in terms of medical expenses, lost future income (production losses), and disability-adjusted life-years (DALYs).
Main Results:
- Total societal costs reached US$3.27 billion (US$46 million medical costs, US$3,222 million production losses) and 3.4 million DALYs.
- Iron-deficiency anemia's impact on cognitive development and vitamin A deficiency-related mortality were the primary cost drivers.
- Costs disproportionately affected poorer households.
Conclusions:
- Micronutrient deficiencies represent a substantial economic burden, equivalent to 1.44% of Pakistan's GDP in 2013.
- Addressing early childhood nutrition and implementing public health measures can eliminate these significant costs.
- Findings support the development of cost-effective interventions to mitigate the lifelong consequences of childhood malnutrition.
Background:
In Pakistan, nearly half of children younger than 5 years are stunted, and 1 in 3 is underweight. Micronutrient deficiencies, a less visible form of undernutrition, are also endemic. They may lead to increased morbidity and mortality as well as to impaired cognitive and physical development.
Objective:
To estimate the lifetime costs of micronutrient deficiencies in Pakistani children aged between 6 and 59 months.
Methods:
We develop a health economic model of the lifetime health and cost consequences of iodine, iron, vitamin A, and zinc deficiencies. We assess medical costs, production losses in terms of future incomes lost, and disability-adjusted life-years (DALYs). The estimation is based on large population surveys, information on the health consequences of micronutrient deficiencies extracted from randomized trials, and a variety of other sources.
Results:
Total societal costs amount to US$46 million in medical costs, US$3,222 million in production losses, and 3.4 million DALYs. Costs are dominated by the impaired cognitive development induced by iron-deficiency anemia in 6- to 23-month-old children and the mortality caused by vitamin A deficiency. Costs are substantially higher in poorer households.
Conclusions:
Societal costs amounted to 1.44% of gross domestic product and 4.45% of DALYs in Pakistan in 2013. These costs hinder the country's development. They could be eliminated by improved nutrition of 6- to 59-month-old children and public health measures. Our results may contribute to the design of cost-effective interventions aiming to reduce micronutrient deficiencies in early childhood and their lifetime consequences.
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