The Mama-SASHA project aimed 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. Nutrition education and vouchers for OFSP vines were provided during antenatal care (ANC) visits, with nutrition education and support provided through pregnant womens clubs. Our objective is to contribute to evidence on cost-effectiveness of integrated agriculture and nutrition interventions.
We estimated total costs using monitoring data, expense reports and key informant interviews. We included the opportunity costs of labor for health workers, community volunteers and participants, and sales and consumption of OFSP and treatment costs averted as economic benefits. We estimated the cost per beneficiary reached and the incremental cost-effectiveness ratio (ICER) of the interventionthe distribution of OFSP vouchers, enhanced nutrition counseling at antenatal care visits 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.
The net economic cost was $445,151, with 3,281 women redeeming vouchers and planting OFSP at a cost of $135 per beneficiary. 55 DALYs were averted per year, mostly attributable to improvements in stunting and anemia. The ICER was US $2,632 per DALY averted.
Given Kenyas GDP of $994 per person and additional benefits of improved sweetpotato yields, household food security, and increased nutritional knowledge of mothers, the intervention was cost-effective.