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Economic Evaluation of Nutrition-Sensitive Agricultural Interventions to Increase Maternal and Child Dietary Diversity and Nutritional Status in Rural Odisha, India.
Haghparast-Bidgoli, Hassan; Harris-Fry, Helen; Kumar, Abhinav; Pradhan, Ronali; Mishra, Naba Kishore; Padhan, Shibananth; Ojha, Amit Kumar; Mishra, Sailendra Narayan; Fivian, Emily; James, Philip; Ferguson, Sarah; Krishnan, Sneha; O'Hearn, Meghan; Palmer, Tom; Koniz-Booher, Peggy; Danton, Heather; Minovi, Sandee; Mohanty, Satyanarayan; Rath, Shibanand; Rath, Suchitra; Nair, Nirmala; Tripathy, Prasanta; Prost, Audrey; Allen, Elizabeth; Skordis, Jolene; Kadiyala, Suneetha.
Afiliación
  • Haghparast-Bidgoli H; University College London, Institute for Global Health, London, United Kingdom.
  • Harris-Fry H; London School of Hygiene & Tropical Medicine, London, United Kingdom.
  • Kumar A; Digital Green, New Delhi, India.
  • Pradhan R; Digital Green, New Delhi, India.
  • Mishra NK; Voluntary Association for Rural Reconstruction and Appropriate Technology (VARRAT), Kendrapada, Odisha, India.
  • Padhan S; Voluntary Association for Rural Reconstruction and Appropriate Technology (VARRAT), Kendrapada, Odisha, India.
  • Ojha AK; Ekjut, Chakradharpur, Jharkhand, India.
  • Mishra SN; Voluntary Association for Rural Reconstruction and Appropriate Technology (VARRAT), Kendrapada, Odisha, India.
  • Fivian E; London School of Hygiene & Tropical Medicine, London, United Kingdom.
  • James P; London School of Hygiene & Tropical Medicine, London, United Kingdom.
  • Ferguson S; Devoted Health, Waltham, MA, USA.
  • Krishnan S; Jindal School of Environment and Sustainability, OP Jindal Global University and ETCH Consultancy Services, Mumbai, Maharashtra, India.
  • O'Hearn M; Tufts University Friedman School of Nutrition Science and Policy, Boston, MA, USA.
  • Palmer T; University College London, Institute for Global Health, London, United Kingdom.
  • Koniz-Booher P; SI Research & Training Institute, Inc. Arlington, VA, USA.
  • Danton H; SI Research & Training Institute, Inc. Arlington, VA, USA.
  • Minovi S; SI Research & Training Institute, Inc. Arlington, VA, USA.
  • Mohanty S; DCOR Consulting Pvt. Ltd. Bhubaneshwar, India.
  • Rath S; Ekjut, Chakradharpur, Jharkhand, India.
  • Rath S; Ekjut, Chakradharpur, Jharkhand, India.
  • Nair N; Ekjut, Chakradharpur, Jharkhand, India.
  • Tripathy P; Ekjut, Chakradharpur, Jharkhand, India.
  • Prost A; University College London, Institute for Global Health, London, United Kingdom.
  • Allen E; London School of Hygiene & Tropical Medicine, London, United Kingdom.
  • Skordis J; University College London, Institute for Global Health, London, United Kingdom.
  • Kadiyala S; London School of Hygiene & Tropical Medicine, London, United Kingdom.
J Nutr ; 152(10): 2255-2268, 2022 10 06.
Article en En | MEDLINE | ID: mdl-35687367
BACKGROUND: Economic evaluations of nutrition-sensitive agriculture (NSA) interventions are scarce, limiting assessment of their potential affordability and scalability. OBJECTIVES: We conducted cost-consequence analyses of 3 participatory video-based interventions of fortnightly women's group meetings using the following platforms: 1) NSA videos; 2) NSA and nutrition-specific videos; or 3) NSA videos with a nutrition-specific participatory learning and action (PLA) cycle. METHODS: Interventions were tested in a 32-mo, 4-arm cluster-randomized controlled trial, Upscaling Participatory Action and Videos for Agriculture and Nutrition (UPAVAN) in the Keonjhar district, Odisha, India. Impacts were evaluated in children aged 0-23 mo and their mothers. We estimated program costs using data collected prospectively from expenditure records of implementing and technical partners and societal costs using expenditure assessment data collected from households with a child aged 0-23 mo and key informant interviews. Costs were adjusted for inflation, discounted, and converted to 2019 US$. RESULTS: Total program costs of each intervention ranged from US$272,121 to US$386,907. Program costs per pregnant woman or mother of a child aged 0-23 mo were US$62 for NSA videos, US$84 for NSA and nutrition-specific videos, and US$78 for NSA videos with PLA (societal costs: US$125, US$143, and US$122, respectively). Substantial shares of total costs were attributable to development and delivery of the videos and PLA (52-69%) and quality assurance (25-41%). Relative to control, minimum dietary diversity was higher in the children who underwent the interventions incorporating nutrition-specific videos and PLA (adjusted RRs: 1.19 and 1.27; 95% CIs: 1.03-1.37 and 1.11, 1.46, respectively). Relative to control, minimum dietary diversity in mothers was higher in those who underwent NSA video (1.21 [1.01, 1.45]) and NSA with PLA (1.30 [1.10, 1.53]) interventions. CONCLUSION: NSA videos with PLA can increase both maternal and child dietary diversity and have the lowest cost per unit increase in diet diversity. Building on investments made in developing UPAVAN, cost-efficiency at scale could be increased with less intensive monitoring, reduced startup costs, and integration within existing government programs. This trial was registered at clinicaltrials.gov as ISRCTN65922679.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estado Nutricional / Dieta Tipo de estudio: Clinical_trials / Diagnostic_studies / Health_economic_evaluation Límite: Child / Female / Humans / Pregnancy País/Región como asunto: Asia Idioma: En Revista: J Nutr Año: 2022 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estado Nutricional / Dieta Tipo de estudio: Clinical_trials / Diagnostic_studies / Health_economic_evaluation Límite: Child / Female / Humans / Pregnancy País/Región como asunto: Asia Idioma: En Revista: J Nutr Año: 2022 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Estados Unidos