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Cost-effectiveness of antenatal multiple micronutrients and balanced energy protein supplementation compared to iron and folic acid supplementation in India, Pakistan, Mali, and Tanzania: A dynamic microsimulation study
- Source :
- PLoS Medicine. February 22, 2022, Vol. 19 Issue 2, e1003902
- Publication Year :
- 2022
-
Abstract
- Background Malnutrition among women of childbearing age is especially prevalent in Asia and sub-Saharan Africa and can be harmful to the fetus during pregnancy. In the most recently available Demographic and Health Survey (DHS), approximately 10% to 20% of pregnant women in India, Pakistan, Mali, and Tanzania were undernourished (body mass index [BMI] Methods and findings Using nationally representative estimates from the 2017 GBD study, we conducted an individual-based dynamic microsimulation of population cohorts from birth to 2 years of age in India, Pakistan, Mali, and Tanzania. We modeled the effect of maternal nutritional supplementation on infant birth weight, stunting and wasting using effect sizes from Cochrane systematic reviews and published literature. We used a payer's perspective and obtained costs of supplementation per pregnancy from the published literature. We compared disability-adjusted life years (DALYs) and incremental cost-effectiveness ratios (ICERs) in a baseline scenario with existing antenatal IFA coverage with scenarios where 90% of antenatal care (ANC) attendees receive either universal MMS, universal BEP, or MMS + targeted BEP (women with prepregnancy BMI Conclusions In this study, we observed that MMS + targeted BEP averts more DALYs and remains cost-effective compared to universal MMS. As countries consider using MMS in alignment with recent WHO guidelines, offering targeted BEP is a cost-effective strategy that can be considered concurrently to maximize benefits and synergize program implementation.<br />Author(s): Nicole Young *, Alison Bowman, Kjell Swedin, James Collins, Nathaniel D. Blair-Stahn, Paulina A. Lindstedt, Christopher Troeger, Abraham D. Flaxman Introduction Pregnancy requires increased energy and nutritional consumption to [...]
- Subjects :
- Iron in the body -- Health aspects -- Comparative analysis
Proteins in human nutrition -- Health aspects -- Comparative analysis
Medical care, Cost of -- Analysis
Folic acid -- Health aspects -- Comparative analysis
Malnutrition -- Diet therapy -- Complications and side effects
Dietary supplements -- Comparative analysis -- Health aspects
Pregnant women -- Health aspects -- Food and nutrition
Prenatal influences -- Health aspects
Biological sciences
Subjects
Details
- Language :
- English
- ISSN :
- 15491277
- Volume :
- 19
- Issue :
- 2
- Database :
- Gale General OneFile
- Journal :
- PLoS Medicine
- Publication Type :
- Academic Journal
- Accession number :
- edsgcl.696084143
- Full Text :
- https://doi.org/10.1371/journal.pmed.1003902