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Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: Reducing micronutrient deficiencies in Pakistani children : are subsidies on fortified complementary foods cost-effective?
Authors: Wieser, Simon
Brunner, Beatrice
Tzogiou, Christina
Plessow, Rafael
Zimmermann, Michael B.
Farebrother, Jessica
Soofi, Sajid
Bhatti, Zaid
Ahmed, Imran
Bhutta, Zulfiqar A.
DOI: 10.21256/zhaw-3445
Published in: Public Health Nutrition
Volume(Issue): 21
Issue: 15
Page(s): 2893
Pages to: 2906
Issue Date: 2018
Publisher / Ed. Institution: Cambridge University Press
ISSN: 1368-9800
Language: English
Subjects: Child; Complementary food; Cost-effective; Malnutrition; Micronutrient; Pakistan; Subsidy
Subject (DDC): 613.2: Dietetics
Abstract: Objective: To estimate the cost-effectiveness of price subsidies on fortified packaged complementary foods (FPCF) in reducing iodine deficiency, iron-deficiency anaemia and vitamin A deficiency in Pakistani children. Design: The study proceeded in three steps: (i) we determined the current lifetime costs of the three micronutrient deficiencies with a health economic model; (ii) we assessed the price sensitivity of demand for FPCF with a market survey in two Pakistani districts; (iii) we combined the findings of the first two steps with the results of a systematic review on the effectiveness of FPCF in reducing micronutrient deficiencies. The cost-effectiveness was estimated by comparing the net social cost of price subsidies with the disability-adjusted life years (DALY) averted. Setting: Districts of Faisalabad and Hyderabad in Pakistan. Subjects: Households with 6–23-month-old children stratified by socio-economic strata. Results: The lifetime social costs of iodine deficiency, iron-deficiency anaemia and vitamin A deficiency in 6-23-month-old children amounted to production losses of $US 209 million and 175 000 DALY. Poor households incurred the highest costs, yet even wealthier households suffered substantial losses. Wealthier households were more likely to buy FPCF. The net cost per DALY of the interventions ranged from a return per DALY averted of $US 783 to $US 65. Interventions targeted at poorer households were most cost-effective. Conclusions: Price subsidies on FPCF might be a cost-effective way to reduce the societal costs of micronutrient deficiencies in 6–23-month-old children in Pakistan. Interventions targeting poorer households are especially cost-effective.
Fulltext version: Published version
License (according to publishing contract): CC BY 4.0: Attribution 4.0 International
Departement: School of Management and Law
Organisational Unit: Winterthur Institute of Health Economics (WIG)
Appears in collections:Publikationen School of Management and Law

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