Costs and Cost-Effectiveness of Nutrition Interventions | | | | Costs (US$) |
| Type of deficiency and intervention | Source | Year | Country | Per child or per outcome | Per death averted | Per DALY gained |
| Underweight |
| Breastfeeding support | Horton and others 1996 | 1996 | Brazil, Honduras, Mexico | 0.30-0.40 per birth; 0.65-1.10 per diarrhea case averted | 100-200 | 3-7 |
| Breastfeeding promotion | Ross, Loening, and Mbele 1987 | 1987 | Mali | 2-3 per child | 282 | 11 |
| Breastfeeding promotion | Chee, Makinen, and Sakagawa 2002 | 2002 | Ghana | 16 per child; 5-58 per adopter of exclusive breastfeeding | 203a | 7.80 |
| Chee and others 2003 | 2003 | Madagascar | 4.41 per child; 10-17 per adopter of exclusive breastfeeding | — | — |
| Child survival program with nutrition component | J. Ross 1997; WHO 2002 | 1997 | Across programs | 76-101 per undernourished child averted | 1,200 | 41-43 |
| Nutrition programs |
| Less intensive | | | | 2-5 per child | | |
| More intensive | | | | 5-10 per child | | |
| Growth monitoring and counseling | Fiedler 2003 | 2003 | Honduras | 4 per child; 20 per under-nourished child averted | 240-320b | 8-11 |
| Vitamin A deficiency |
| Capsule distribution | Rassas, Hottor, and others 2004 | 2004 | Ghana | 0.90 per child | 277 | 11 |
| Rassas, Nakamba, and others 2004 | 2004 | Zambia | 1.23 per child | 162 | 6-7 |
| Fiedler 2000 | 2000 | Nepal | 1.25 per child | 327 | 11-12 |
| Fiedler and others 2000 | 1994 | | | | |
| Fortification | Institute of Medicine 1998; World Bank 1994 | | Guatemala | 0.17 per child | 1,000 | 33-35 |
| Sugar | | | | 0.05-0.15 per child | | |
| Other | | | | | | |
| Iron deficiency |
| Supplements | Institute of Medicine 1998; World Bank 1994 | 1994 | | 3.17-5.30 per child | | |
| Fortification |
| Salt | World Bank 1994 | 1994 | India | 0.12 per child | — | — |
| Sugar | World Bank 1994 | 1994 | Guatemala | 0.20-1.00 per child | — | — |
| Cereal | World Bank 1994 | | | 0.09 per child | 2,000 | 66-70 |
| Iodine deficiency | Institute of Medicine 1998; World Bank 1994 | | | | | |
| Oil injection | | 1994 | Peru | 2.75 per child | — | — |
| | | Zaire | 0.80 per child | | |
| | | | 1.25 per child | | |
| Fortification |
| Water | | | Indonesia | 0.05 per child | | |
| Salt | | | Italy | 0.02-0.05 per child | 1,000 | 34-36 |
| Salt | | | India | 0.05 per child | | |
| Zinc deficiency |
| Supplements with oral rehydration salts | Robberstad and others 2004 | 2004 | n.a. | 0.47 per child | 2,100 | 73 |
Source: [Add Source]
— = not available; n.a. = not applicable.
Note: Deaths prevented by promoting or supporting breastfeeding are assumed to occur around age one. Deaths prevented by other programs to reduce underweight and all programs to reduce micronutrient deficiency are assumed to occur between ages one and five. Authors' estimates of costs per DALY (in parentheses) using region-specific life expectancies at ages one and five, reflect this range.
a. Assumes that all the DALY gains come from preventing deaths.
b. Assumes that an undernourished child has a chance of 1 in 16 to 1 in 12 (6 to 8 percent) of dying before age five, the same as estimated for child survival programs.
