3 results on '"Rafael Plessow"'
Search Results
2. Burden of Micronutrient Deficiencies by Socio-economic Strata in Children aged 6 Months to 5 years in the Philippines
- Author
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Urs Bruegger, Klaus Eichler, Simon Wieser, Olivia Malek, Imelda Agdeppa, Mario V Capanzana, and Rafael Plessow
- Subjects
Gerontology ,Micronutrient deficiency ,Philippines ,Quality-adjusted life year ,Health care cost ,616: Innere Medizin und Krankheiten ,Vitamin A deficiency ,Prevalence ,Medicine ,Micronutrient ,Micronutrients ,Vitamin A ,Child ,Socioeconomics ,health care economics and organizations ,education.field_of_study ,DALY ,Age factor ,Age Factors ,Burden of disease ,Health Care Costs ,Iron Deficiencies ,Intangible costs ,Zinc ,Geography ,Child, Preschool ,Cost of illness ,Quality-Adjusted Life Years ,Research Article ,Human ,Micronutrient deficiencies ,medicine.medical_specialty ,Socioeconomic factor ,Iron ,Population ,Developing country ,Environmental health ,618.92: Pädiatrie ,Humans ,education ,Preschool ,Socioeconomic status ,Nutrition ,Health economics ,business.industry ,Public health ,Cost-of-illness ,Public Health, Environmental and Occupational Health ,Production losses ,Infant ,Socioeconomic Factors ,Biostatistics ,business - Abstract
Background: Micronutrient deficiencies (MNDs) are a chronic lack of vitamins and minerals and constitute a huge public health problem. MNDs have severe health consequences and are particularly harmful during early childhood due to their impact on the physical and cognitive development. We estimate the costs of illness due to iron deficiency (IDA), vitamin A deficiency (VAD) and zinc deficiency (ZnD) in 2 age groups (6-23 and 24-59 months) of Filipino children by socio-economic strata in 2008. Methods: We build a health economic model simulating the consequences of MNDs in childhood over the entire lifetime. The model is based on a health survey and a nutrition survey carried out in 2008. The sample populations are first structured into 10 socio-economic strata (SES) and 2 age groups. Health consequences of MNDs are modelled based on information extracted from literature. Direct medical costs, production losses and intangible costs are computed and long term costs are discounted to present value. Results: Total lifetime costs of IDA, VAD and ZnD amounted to direct medical costs of 30 million dollars, production losses of 618 million dollars and intangible costs of 122,138 disability adjusted life years (DALYs). These costs can be interpreted as the lifetime costs of a 1-year cohort affected by MNDs between the age of 6โ59 months. Direct medical costs are dominated by costs due to ZnD (89% of total), production losses by losses in future lifetime (90% of total) and intangible costs by premature death (47% of total DALY losses) and losses in future lifetime (43%). Costs of MNDs differ considerably between SES as costs in the poorest third of the households are 5 times higher than in the wealthiest third. Conclusions: MNDs lead to substantial costs in 6-59-month-old children in the Philippines. Costs are highly concentrated in the lower SES and in children 6-23 months old. These results may have important implications for the design, evaluation and choice of the most effective and cost-effective policies aimed at the reduction of MNDs.
- Published
- 2015
3. Cost-Effectiveness of Price Subsidies on Fortified Packaged Infant Cereals in Reducing Iron Deficiency Anemia in 6-23-Month-Old-Children in Urban India
- Author
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Beatrice Brunner, Narendra Kumar Arora, Rafael Plessow, and Simon Wieser
- Subjects
Male ,0301 basic medicine ,Financing, Government ,Urban Population ,Economics ,Cost effectiveness ,Cost-Benefit Analysis ,Social Sciences ,lcsh:Medicine ,Geographical Locations ,Families ,0302 clinical medicine ,Cost of Illness ,hemic and lymphatic diseases ,Medicine and Health Sciences ,Medicine ,030212 general & internal medicine ,Early childhood ,lcsh:Science ,Children ,Multidisciplinary ,Anemia, Iron-Deficiency ,Anemia ,Subsidy ,Hematology ,Iron deficiency ,Research Assessment ,Food, Fortified ,Female ,Public Health ,Quality-Adjusted Life Years ,Infants ,Research Article ,medicine.medical_specialty ,Asia ,Systematic Reviews ,Death Rates ,Cost-Effectiveness Analysis ,India ,Research and Analysis Methods ,03 medical and health sciences ,Population Metrics ,Environmental health ,Humans ,Iron Deficiency Anemia ,Poverty ,Demography ,030109 nutrition & dietetics ,Population Biology ,business.industry ,Public health ,lcsh:R ,Infant ,Biology and Life Sciences ,nutritional and metabolic diseases ,medicine.disease ,Economic Analysis ,Iron-deficiency anemia ,Age Groups ,People and Places ,Population Groupings ,lcsh:Q ,Edible Grain ,business - Abstract
Introduction Iron deficiency anaemia (IDA) is a major public health problem in India and especially harmful in early childhood due to its impact on cognitive development and increased all-cause mortality. We estimate the cost-effectiveness of price subsidies on fortified packaged infant cereals (F-PICs) in reducing IDA in 6-23-monthold children in urban India. Materials and Methods Cost-effectiveness is estimated by comparing the net social cost of price subsidies with the disability-adjusted life-years (DALYs) averted with price subsidies. The net social costs correspond to the cost of the subsidy minus the monetary costs saved by reducing IDA. The estimation proceeds in three steps: 1) the current lifetime costs of IDA are assessed with a health economic model combining the prevalence of anemia, derived from a large population survey, with information on the health consequences of IDA and their costs in terms of mortality, morbidity, and DALYs. 2) The effects of price subsidies on the demand for F-PICs are assessed with a market survey among 4801 households in 12 large Indian cities. 3) The cost-effectiveness is calculated by combining the findings of the first two steps with the results of a systematic review on the effectiveness of F-PICs in reducing IDA. We compare the cost-effectiveness of interventions that differ in the level of the subsidy and in the socio-economic strata (SES) eligible for the subsidy. Results The lifetime social costs of IDA in 6-23-month-old children in large Indian cities amount to production losses of 3222 USD and to 726,000 DALYs. Poor households incur the highest costs, yet even wealthier households suffer substantial losses. The market survey reveals that few households currently buy F-PICs, with the share ranging from 14% to 36%. Wealthier households are generally more likely to buy FPICs. The costs of the subsidies per DALY averted range from 909 to 3649 USD. Interventions targeted at poorer households are most effective. Almost all interventions are cost saving from a societal perspective when taking into account the reduction of future production losses. Return per DALY averted ranges between gains of 1655 USD to a cost of 411 USD. Conclusion Price subsidies on F-PICs are a cost-effective way to reduce the social costs of IDA in 6-23-month-old children in large Indian cities. Interventions targeting poorer households are especially cost-effective.
- Published
- 2016
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