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Cost-effectiveness of community-based screening and treatment of moderate acute malnutrition in Mali

Sheila Isanaka1, Dale A Barnhart2, Christine M McDonald3

  • 1Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.

BMJ Global Health
|May 30, 2019
PubMed

Insights

Ready-to-use supplementary foods (RUSF) effectively reduce child mortality from moderate acute malnutrition (MAM). This cost-effective intervention offers significant health benefits for children under five.

Area of Science:

  • Public Health
  • Nutrition Science
  • Health Economics

Background:

  • Moderate acute malnutrition (MAM) significantly contributes to child mortality and morbidity globally.
  • Effective treatment of MAM is crucial to prevent progression to severe acute malnutrition and reduce child deaths.

Purpose of the Study:

  • To evaluate the health outcomes, costs, and cost-effectiveness of four dietary supplements for MAM treatment in children aged 6-35 months in Mali.
  • To compare ready-to-use supplementary foods (RUSF), corn-soy blend (CSB++), Misola (MI), and locally milled flour (LMF) for MAM management.

Main Methods:

  • A cluster-randomised trial was conducted to assess nutritional outcomes of different MAM treatments.
  • A decision tree model was employed to estimate long-term health outcomes and calculate incremental cost-effectiveness ratios (ICERs).

Main Results:

  • MAM treatment with RUSF, CSB++, MI, and LMF reduced mortality risk by 15.4%, 12.7%, 11.9%, and 10.3%, respectively, compared to no treatment.
  • The ICER for RUSF was US$9821 per death averted and US$347 per DALY averted, indicating favorable cost-effectiveness.

Conclusions:

  • Treatment of moderate acute malnutrition with RUSF is a cost-effective strategy.
  • RUSF demonstrates cost-effectiveness across various willingness-to-pay thresholds, making it a viable option for MAM intervention.
Abstract

Keywords:
CSB++MaliPlumpySupSuper Cerealcorn soy blendcostcost-effectivenessmoderate acute malnutritionready to use supplementary foods

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