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Global Nutrition (Poster Session)

(P24-008-24) The Cost and Cost-Effectiveness of Integrating Wasting Prevention Into Screening in Facility- and Community-Based Platforms in Burkina Faso and Mali

Monday, July 1, 2024
11:45 AM – 12:45 PM CT
Location: Poster Board 151

    Presenting Author(s)

  • RB

    Rebecca Brander, PhD MPH

    Research Fellow
    International Food Policy Research Institute
    Washington, District of Columbia, United States

    • Co-Author(s)

  • Chloe Puett, PhD

    Research Faculty
    Stony Brook University
    Stony Brook, New York, United States

  • EB

    Elodie Becquey

    International Food Policy Research Institute, Senegal

  • Jef L. Leroy, PhD

    Senior Research Fellow
    International Food Policy Research Institute
    Washington, District of Columbia, United States

  • MR

    Marie Ruel, PhD

    International Food Policy Research Institute
    WASHINGTON, District of Columbia, United States

  • FS

    Fidele Eric Sessou

    UNICEF, Italy

  • HL

    Huybregts Lieven

    International Food Policy Research Institute, United States

Disclosure(s):
Rebecca Brander, PhD MPH: No relevant financial relationship(s) with ineligible companies to disclose.
Jef L. Leroy, PhD: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: The release of the new WHO guideline on the prevention and treatment of child wasting identified a dearth of rigorous evidence on the cost-effectiveness of wasting-related interventions, and especially so for interventions that integrate prevention into screening. We estimated the cost and cost-effectiveness of integrating prevention interventions - behavior change communication (BCC) and small quantity lipid-based nutrient supplements (SQ-LNS) - into a facility-based platform in Burkina Faso with enhanced BCC and a community-based platform in Mali with standard BCC.

Methods: We used activity-based costing to estimate costs per child-contact, using data from accounting records, interviews, surveys, and observations. We used a Markov model to estimate costs per disability-adjusted life year (DALY) averted using data from the parent randomized controlled trials on impact on wasting incidence and treatment coverage.

Results: In the intervention group in Burkina Faso, the costs per child-contact of facility-based screening, enhanced BCC, and SQ-LNS were $0.85, $4.28, and $8.86, respectively. In Mali, community-based screening, standard BCC, and SQ-LNS costs were $0.57, $0.72, and $4.14, respectively. Unit costs for the intervention group were higher in Burkina Faso than Mali due to higher general program costs, staff/supervision, and SQ-LNS storage/handling. SQ-LNS constituted the largest cost component in both countries. Although no SQ-LNS costs were incurred in the comparison groups (hence lower total costs), costs per child-contact for screening and BCC were higher, because coverage of these services was lower. The intervention package cost $1073 per DALY averted in Burkina Faso and $747 in Mali.

Conclusions: Integration of wasting prevention, especially SQ-LNS, into screening led to higher total costs but lower unit costs than standard screening due to increased coverage by boosting participation in screening. Greater cost-effectiveness could be achieved if BCC was more effective in improving caregiver health/nutrition practices and if the increased identification of wasted children triggered higher treatment coverage.

Funding Sources: Global Affairs Canada