Suchergebnisse

This report provides recommendations to further develop the methodology for nutrition expenditure analysis. This report carefully reviewed all available nutrition expenditure analyses available and drew methodological conclusions. Findings include a need for a standardized way of classifying nutrition-related spending to be applied, of which the 2013 Lancet Framework lends itself well. Government spending should be mapped against this framework to the extent possible. Government expenditure data as available from the FMIS should be used. Coding for nutrition should be done against activity descriptions in the budget. Merely looking at spending agencies or programs/subprograms is unlikely to be sufficiently precise to be helpful for an analysis and should only be used if the former not be available. Weighting nutrition spending tends to be subjective and should not be used for comparison. It is important to consider the adequacy of the institutional and public financial management environment. This can provide for actionable recommendations on how to improve the management of nutrition across governments, strengthen accountability, and help adjust spending toward high impact interventions. Optima can be used to inform allocative efficiency. It should however be interpreted with care if the unit cost estimates cannot be fully derived from Government and donor expenditure reports of all high impact interventions.

This paper builds on global experience and Uganda's specific context to estimate costs,benefits, and cost-effectiveness of key nutrition interventions. It is intended to help guide theselection of the most cost-effective interventions as well as strategies for scaling these up. Thepaper considers both relevant "nutrition-specific" interventions, largely delivered through thehealth sector, and multisectoral "nutrition-sensitive" interventions, delivered through other sectors such as agriculture, education, and water and sanitation. We estimate that the costs and benefits of implementing 10 nutrition-specific interventions in all regions of Uganda would require a yearly public investment of $68 million. The expected benefits are enormous: annually over 8,000 lives would be saved, while at least 375,000 DALYs and 8,700 cases of stunting among children under five would be averted. Economic productivity could potentially increase by $280 million annually over the productive lives of the beneficiaries, with an impressive internal rate of return of 18 percent. However, because it is unlikely that the Government of Uganda or its partners will be able to find the $68 million necessary to reach full coverage, we also consider scale-up scenarios based on considerations of their potential for impact, burden of stunting, resource requirements, and implementation capacity. The most cost-effective scenario considered would provide a subset of key interventions in regions with the highest rates of stunting and would cost between $19 and $60 million, depending on how many regions are covered. We then identify and cost five nutrition sensitive interventions relevant to Uganda for which there is both evidence of positive impact on nutrition outcomes and some cost information. These findings point to a powerful set of nutrition specific interventions and a candidate list of nutrition-sensitive approaches that represent a highly cost-effective approach to reducing child malnutrition in Uganda.

This paper builds on global experience and the DRC's specific context to identify an effective nutrition approach along with costs and benefits of key nutrition interventions. It is intended to help guide the selection of the most cost-effective interventions as well as strategies for scaling these up. The paper considers both relevant 'nutrition-specific' interventions, largely delivered through the health sector, and multisectoral 'nutrition-sensitive' interventions, delivered through other sectors such as agriculture, education, and water and sanitation. The authors estimate that the costs and benefits of implementing 10 nutrition-specific interventions in all provinces of the DRC would require a yearly public investment of $371 million. The expected benefits are enormous: annually over 5.4 million DALYs and over 76,000 lives would be saved, while at least 1 million cases of stunting among children under five would be averted. Economic productivity could potentially increase by $591 million annually over the productive lives of the beneficiaries, with an impressive internal rate of return of 13.6 percent. However, because it is unlikely that the Government of the DRC or its partners will find the $371 million necessary to reach full coverage, authors also consider scale-up scenarios based on considerations of their potential for impact, burden of stunting, resource requirements, and implementation capacity. The most cost-effective scenario considered would provide a subset of key interventions in provinces with the highest rates of stunting and will cost between $97 and $185 million depending on how many provinces are covered. The authors then identify and cost six nutrition-sensitive interventions relevant to the DRC and for which there are both evidence of positive impact on nutrition outcomes and some cost information. These findings point to a powerful set of nutrition-specific interventions and a candidate list of nutrition-sensitive approaches that represent a highly cost-effective approach to reducing child malnutrition in the DRC.

This paper builds on global experience and Zambia's specific context to identify aneffective nutrition approach along with costs and benefits of key nutrition interventions. It isintended to help guide the selection of the most cost-effective interventions as well as strategiesfor scaling these up. The paper considers both relevant "nutrition-specific" interventions, largelydelivered through the health sector, and multisectoral "nutrition-sensitive" interventions, delivered through other sectors such as agriculture, education, and water and sanitation. We estimate that the costs and benefits of implementing 10 nutrition-specific interventions would require an annual public investment of $40.5 million and would avert over 112,000 DALYs, save over 2,800 lives, and prevent 62,000 cases of stunting. Economic productivity could potentially increase by $915 million annually over the productive lives of the beneficiaries, with an impressive internal rate of return of 32 percent. However, because it is unlikely that the Government of the Zambia or its partners will find the $40.5 million necessary each year to reach full coverage, we also consider scale-up scenarios based on considerations of their potential for impact, burden of stunting, resource requirements, and implementation capacity. The two scenarios that scale up the nine most cost-effective nutrition-specific interventions (excluding the public provision of complementary foods) are the most advantageous in terms of cost-effectiveness and resource requirements and would require $11 million to scale up to partial levels and $23 to scale up to full coverage levels. Among the 8 nutrition-specific interventions we consider, school-baseddeworming is low cost and effective. The interventions we reviewed in the agriculture sector areexpensive when compared to nutrition-specific interventions, although very little cost effectiveness data are available for the nutrition-sensitive interventions to make carefulcomparisons. These findings point to a powerful set of nutrition-specific interventions and acandidate list of nutrition-sensitive approaches that represent a highly cost-effective approach toreducing child malnutrition in Zambia.

This paper builds on global experience and Kenya's specific context to identify an effective approach to scaling up nutrition and provide an estimate of costs and benefits of key nutrition interventions. It is intended to help guide the selection of the most cost-effective interventions as well as strategies for scaling up a package of interventions tailored to Kenya's specific needs. The paper considers high-impact nutrition-specific interventions that largely rely on typical health sector delivery mechanisms. The authors estimate that the costs and benefits of implementing 11 critical nutrition-specific interventions will require a yearly public and donor investment of 76 million dollars. The expected benefits will be substantial: annually more than 455,000 disability adjusted life years (DALYs) will be averted, over 5,000 lives saved, and more than almost 700,000 cases of stunting among children under five averted. This investment will be very cost-effective with an estimated cost per DALY averted of 207 dollars cost per life saved of about 18,600 dollars and a cost per case of stunting averted of 135 dollars. Economic productivity can potentially increase by 458 million dollars over the productive lives of beneficiaries. However, the authors also calculate intermediate scale-up scenarios since it may not be feasible for the Government of Kenya or its partners to achieve full coverage in the near term. The authors compare the costs and benefits associated with three different scenarios: first, prioritizing counties, focusing the investment on counties with a high burden of stunting; second, prioritizing interventions, focusing on only a subset of the most effective interventions; and third, prioritizing both counties and interventions, delivering only the most effective subset of interventions to high-burden counties. The authors determined that the third scenario is the most cost-effective and least costly. Scaling up the most cost-effective interventions in 37 high-burden counties will avert almost 295,000 DALYs and save over 3,000 lives per year for an annual public and donor investment of 48 million dollars.

The economic crisis and food and health system disruptions related to the COVID-19 pandemic threaten to exacerbate undernutrition in low- and middle-income countries (LMICs). We developed pessimistic, moderate and optimistic scenarios for 2020–2022 and used three modelling tools (MIRAGRODEP, the Lives Saved Tool and Optima Nutrition) to estimate the impacts of pandemic-induced disruptions on child stunting, wasting and mortality, maternal anaemia and children born to women with a low body mass index (BMI) in 118 LMICs. We estimated the cost of six nutrition interventions to mitigate excess stunting and child mortality due to the pandemic and to maximize alive and non-stunted children, and used the human capital approach to estimate future productivity losses. By 2022, COVID-19-related disruptions could result in an additional 9.3 million wasted children and 2.6 million stunted children, 168,000 additional child deaths, 2.1 million maternal anaemia cases, 2.1 million children born to women with a low BMI and US$29.7 billion in future productivity losses due to excess stunting and child mortality. An additional US$1.2 billion per year will be needed to mitigate these effects by scaling up nutrition interventions. Governments and donors must maintain nutrition as a priority, continue to support resilient systems and ensure the efficient use of new and existing resources. ; PR ; IFPRI3; CRP4; 2 Promoting Healthy Diets and Nutrition for all; G Cross-cutting gender theme; Advancing Research on Nutrition and Agriculture (ARENA); Ceres2030 ; DSGD; MTID; PHND; A4NH ; CGIAR Research Programs on Agriculture for Nutrition and Health (A4NH)