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Cost‐effectiveness of Mama‐SASHA: a project to improve health and nutrition through an integrated orange‐fleshed sweetpotato production and health service delivery model
Author(s) -
Self Julie,
Webb Girard Amy,
McFarland Deborah,
Grant Frederick,
Low Jan,
Cole Donald,
Levin Carol
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.39.8
Subject(s) - medicine , environmental health , per capita , cost effectiveness , psychological intervention , wasting , food security , malnutrition , agriculture , nursing , population , geography , archaeology , risk analysis (engineering) , endocrinology , pathology
The Mama‐SASHA project aims to improve the health and nutrition of pregnant/lactating women and children <2 years through an integrated orange‐fleshed sweetpotato (OFSP) and health service strategy in Western Kenya. We analyzed the cost effectiveness from a societal perspective. We estimated the incremental cost‐effectiveness ratio (ICER) of the intervention, which includes OFSP vouchers provided at antenatal care (ANC) visits, nutrition education, and pregnant women's clubs, compared to status quo ANC services. Effectiveness data from a quasi‐experimental study were used to estimate DALYs associated with changes in vitamin A deficiency, stunting, wasting, anemia, diarrhea, and mortality for children <2 years and their mothers. We used ingredients based micro‐costing to estimate economic costs of agriculture, health and community interventions, including opportunity costs of labor for health workers, community volunteers and participants.
Net economic cost over three years was US @445,151. 77 DALYs were averted per year, mostly attributable to improvements in stunting and anemia. The ICER was US @1,919 per DALY averted, which is two times Kenya's GDP per capita (@994 per person) and meets cost‐effectiveness criteria set by WHO. Benefits not convertible into DALY's include improved sweetpotato yield, food security, extension services and nutritional knowledge.