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Cost-effectiveness Analysis of Crèche Combined with Community-based Nutrition Promotion Interventions for Children in
1Department of Finance, Jaipuria Institute of Management, Jaipur, Rajasthan, India.
Insights
Integrating crèches with community nutrition programs effectively reduces child undernutrition in India. This combined intervention is a cost-effective strategy for improving child health and resource allocation.
Area of Science:
- Public Health
- Nutrition Science
- Health Economics
Background:
- Child undernutrition remains a critical public health issue in India.
- High prevalence necessitates effective and scalable interventions.
- Existing strategies require evaluation for optimal impact.
Purpose of the Study:
- To evaluate the effectiveness of a combined crèche and community nutrition promotion intervention.
- To assess the cost-effectiveness of this integrated approach for reducing child undernutrition.
- To provide evidence for resource allocation in public health programs.
Main Methods:
- Provider perspective cost analysis comparing intervention and control groups.
- Effectiveness measured by the Composite Index of Anthropometric Failure (CIAF).
- Cost-effectiveness calculated using the incremental cost-effectiveness ratio (ICER) against Disability-Adjusted Life Years (DALYs) averted.
Main Results:
- The intervention demonstrated significant cost-effectiveness.
- Incremental cost per CIAF case averted: US$2791.
- Incremental cost per DALY averted: US$514, below India's GDP per capita threshold.
Conclusions:
- Integrating crèches with community nutrition promotion is an effective and affordable strategy.
- This integrated model significantly reduces child undernutrition.
- Implementation within existing health systems is crucial for national impact.
Background:
The prevalence of child undernutrition is significantly high in India, prompting a study to evaluate the effectiveness of a crèche combined with community-based nutrition promotion interventions aimed at reducing undernutrition among children aged 6-36 months in two Indian states. This study also assessed the cost-effectiveness of this intervention for optimal resource allocation.
Method:
Using a provider's perspective, the study analyzed project costs associated with the intervention, which was compared to a control group. The effectiveness was measured through the Composite Index of Anthropometric Failure (CIAF), with costs gathered from project accounts and outcomes analyzed through baseline and endline surveys. To assess the cost-effectiveness of the intervention, the incremental cost-effectiveness ratio was calculated, taking the difference in total costs of intervention and control areas against the Disability-Adjusted Life Years (DALYs) averted through the intervention. Costs were adjusted for inflation and converted to 2023 US Dollars. To assess the robustness of the results, sensitivity analyses were conducted.
Results:
The incremental cost per CIAF case averted was US$2791, while the incremental cost per DALY averted stood at US$514. This cost-effectiveness was aligned with WHO recommendations, considering it below India's GDP per capita threshold of US$2610.
Conclusion:
In conclusion, the study found that integrating a crèche with community nutrition promotion significantly addresses child undernutrition effectively and affordably. Implementing such interventions into the existing health system is vital for reducing the burden of undernutrition in India.
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