Governments, international organizations and NGOs spend large amounts of money for interventions aiming to reduce nutritional deficiencies. However, it is often not clear whether these interventions work and whether they represent a good value-for-money. The main objective of this contribution is to show how economic evaluations can contribute towards maximizing the cost-effectiveness of micro-nutritional interventions.
The contribution applies the methods of program evaluation developed in the field of health economics to the evaluation of nutritional interventions. A unified framework assessing both the effectiveness and the cost-effectiveness of micro-nutritional interventions is developed and illustrated.
The assessment of the effectiveness of a micro-nutritional intervention should include the assessment of 1) the clinical effectiveness, 2) the effectiveness of the mode of delivery, 3) the compliance of households and 4) the degree of substitution between food sources. The cost-effectiveness plane is used for the comparison of all the costs and benefits of an intervention. It allows a unified treatment of different cost dimensions (intervention costs, direct medical and non-medical costs, production losses, loss of quality of life and life-years). It also allows to switch between different types of evaluations, as between a cost-effectiveness evaluation and a cost-benefit analysis.
The economic evaluation of micro-nutritional interventions can contribute substantially to the design and identification of cost-effective interventions and thus help to achieve the maximum reduction of malnutrition with the limited funds available. The cost-effectiveness framework is a useful tool for the design and evaluation of interventions.