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Comparing costs and cost-efficiency of platforms for micronutrient powder (MNP) delivery to children in rural Uganda
Annals of the New York Academy of Sciences ( IF 4.1 ) Pub Date : 2021-06-24 , DOI: 10.1111/nyas.14621
Whitney Schott 1, 2 , Belinda Richardson 3 , Emily Baker 3 , Alexis D'Agostino 4 , Sorrel Namaste 5 , Stephen A Vosti 6
Affiliation  

Micronutrient powder (MNP) can reduce iron deficiency in young children, which has been well established in efficacy trials. However, the cost of different delivery platforms has not been determined. We calculated the cost and cost-efficiency of distributed MNP through community-based mechanisms and in health facilities in a primarily rural district in Uganda. An endline survey (n = 1072) identified reach and adherence. During the 9-month pilot, 37,458 (community platform) and 12,390 (facility platform) packets of MNP were distributed. Each packet consisted of 30 MNP sachets. In 2016, total costs were $277,082 (community platform, $0.24/sachet) and $221,568 (facility platform, $0.59/sachet). The cost per child reached was lower in the community platform ($53.24) than the facility platform ($65.97). The cost per child adhering to a protocol was $58.08 (community platform) and $72.69 (facility platform). The estimated cost of scaling up the community platform pilot to the district level over 3 years to cover approximately 17,890 children was $1.23 million (scale-up integrated into a partner agency program) to $1.62 million (government scale-up scenario). Unlike previous estimates, these included opportunity costs. Community-based MNP delivery costs were greater, yet more cost-efficient per child reached and adhering to protocol than facility-based delivery. However, total costs for untargeted MNP delivery under program settings are potentially prohibitive.

中文翻译:

比较为乌干达农村儿童提供微量营养素粉 (MNP) 平台的成本和成本效益

微量营养素粉 (MNP) 可以减少幼儿的铁缺乏症,这已在功效试验中得到证实。但是,尚未确定不同交付平台的成本。我们通过基于社区的机制和乌干达主要农村地区的卫生设施计算了分布式 MNP 的成本和成本效益。端线调查 ( n = 1072) 确定了覆盖面和依从性。在为期 9 个月的试点期间,分发了 37,458(社区平台)和 12,390(设施平台)MNP 数据包。每个小包由 30 个 MNP 小袋组成。2016 年,总成本为 277,082 美元(社区平台,0.24 美元/袋)和 221,568 美元(设施平台,0.59 美元/袋)。社区平台(53.24 美元)比设施平台(65.97 美元)获得的每个孩子的成本更低。每个孩子遵守协议的成本为 58.08 美元(社区平台)和 72.69 美元(设施平台)。在 3 年内将社区平台试点扩大到地区一级以覆盖约 17,890 名儿童的估计成本为 123 万美元(扩大到合作伙伴机构计划中)至 162 万美元(政府扩大方案)。与之前的估计不同,这些包括机会成本。基于社区的 MNP 交付成本更高,但与基于设施的交付相比,每个接触到并遵守协议的儿童更具成本效益。然而,在项目设置下无针对性的 MNP 交付的总成本可能令人望而却步。
更新日期:2021-06-24
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