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Cost analysis of probiotic/synbiotic supplementation in infants in rural Kenya: a study from the PROSYNK trial

Beth McCallum1, Mary Iwaret Otiti2, Florence Achieng2

  • 1Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, England, UK bethmccallum@gmail.com.

BMJ Paediatrics Open
|November 28, 2025
PubMed

Insights

Probiotics and synbiotics may be a feasible intervention to improve infant nutrition in Kenya. Programmatic delivery could cost as little as $9.14 per infant, similar to existing nutrition programs.

Area of Science:

  • Public Health
  • Nutrition Science
  • Health Economics

Background:

  • Undernutrition causes 45% of deaths in children under 5 globally.
  • The PRObiotics and SYNbiotics in infants in Kenya (PROSYNK) trial evaluates pro/synbiotic impact on infant gut health, growth, and nutrition.
  • This study focuses on the cost-effectiveness and feasibility of pro/synbiotic interventions in rural Kenya.

Purpose of the Study:

  • To conduct a cost analysis of the PROSYNK trial.
  • To estimate the costs of programmatic pro/synbiotic intervention delivery.
  • To provide feasibility insights for implementing pro/synbiotics in infants aged 0-5 months in Kenya.

Main Methods:

  • A provider perspective costing study combining ingredient, activity-based, and micro-costing approaches.
  • Empirical cost analysis through trial documentation review and time-motion observations.
  • Thematic analysis of key informant interviews to assess implementation feasibility and develop a theoretical program structure.

Main Results:

  • The economic cost of the pro/synbiotic course under trial conditions was $701.61 per participant.
  • Programmatic delivery via community health workers, without a cold chain, is feasible.
  • Estimated incremental economic costs to the Ministry of Health are $9.14 per infant for a full course.

Conclusions:

  • Pro/synbiotic administration in early life appears feasible and cost-effective.
  • The cost is comparable to existing nutrition interventions.
  • Findings offer valuable insights for policymakers on programmatic implementation in Kenya and similar settings.
Abstract

Keywords:
CostingDeveloping CountriesGrowthHealth PolicyLow and Middle Income Countries

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