Objectives
Micronutrient deficiencies (MNDs) in women of childbearing age (WCA) lead to adverse health outcomes in mothers and their children, with considerable social cost implications (treatment costs, production losses and intangible costs). The objective of this study was to develop a framework for a health economic analysis of MNDs in WCA and to provide an overview of the published knowledge of different aspects within this framework.
Methods
We conducted a structured literature review on empirical data for (i) health and cost consequences of maternal MNDs on mothers and their children, on (ii) effectiveness and on (iii) cost-effectiveness of food fortification interventions in WCA. We also reviewed availability and content of health and nutrition surveys in low and middle income countries.
Results
77 studies provide empirical evidence for 12 different micronutrients and nutrition in general. Maternal MNDs can lead to detrimental effects on child health and physical development. Iodine deficiency in WCA shows a negative effect on child cognitive development. Maternal deficiency in 5 micronutrients (iron, iron-folate, vitamin A, vitamin B and calcium) has detrimental effects on the mother’s health. Evidence regarding subsequent cost implications, effectiveness and cost-effectiveness of interventions with food fortification in WCA is limited to few micronutrients (iron, folate, iodine).
Conclusions
Considerable evidence shows the harmful consequences of maternal MNDs on child health. However, little is known on effectiveness and cost-effectiveness of food fortification interventions targeted at mothers. A health economic analysis of MNDs in WCA could contribute to the development of interventions aiming to improve child and maternal health.
