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Randomized Controlled Trial
. 2023 Jan;19(1):e13441.
doi: 10.1111/mcn.13441. Epub 2022 Oct 18.

The economic costs of a multisectoral nutrition programme implemented through a credit platform in Bangladesh

Giang Thai  1 , Amy Margolies  2 , Aulo Gelli  1 , Nasrin Sultana  3 , Esther Choo  4 , Neha Kumar  1 , Carol Levin  4
Affiliations
Randomized Controlled Trial

The economic costs of a multisectoral nutrition programme implemented through a credit platform in Bangladesh

Giang Thai et al. Matern Child Nutr. 2023 Jan.

Abstract

Bangladesh struggles with undernutrition in women and young children. Nutrition-sensitive agriculture programmes can help address rural undernutrition. However, questions remain on the costs of multisectoral programmes. This study estimates the economic costs of the Targeting and Re-aligning Agriculture to Improve Nutrition (TRAIN) programme, which integrated nutrition behaviour change and agricultural extension with a credit platform to support women's income generation. We used the Strengthening Economic Evaluation for Multisectoral Strategies for Nutrition (SEEMS-Nutrition) approach. The approach aligns costs with a multisectoral nutrition typology, identifying inputs and costs along programme impact pathways. We measure and allocate costs for activities and inputs, combining expenditures and micro-costing. Quantitative and qualitative data were collected retrospectively from implementers and beneficiaries. Expenditure data and economic costs were combined to calculate incremental economic costs. The intervention was designed around a randomised control trial. Incremental costs are presented by treatment arm. The total incremental cost was $795,040.34 for a 3.5-year period. The annual incremental costs per household were US$65.37 (Arm 2), USD$114.15 (Arm 3) and $157.11 (Arm 4). Total costs were led by nutrition counselling (37%), agriculture extension (12%), supervision (12%), training (12%), monitoring and evaluation (9%) and community events (5%). Total input costs were led by personnel (68%), travel (12%) and supplies (7%). This study presents the total incremental costs of an agriculture-nutrition intervention implemented through a microcredit platform. Costs per household compare favourably with similar interventions. Our results illustrate the value of a standardised costing approach for comparison with other multisectoral nutrition interventions.

Keywords: costs; international child health nutrition; low income countries; maternal public health; nutritional interventions; programme evaluation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Cost drivers for the TRAIN intervention in Bangladesh by activity type (Source: Authors). TRAIN, Targeting and Realigning Agriculture to Improve Nutrition.
Figure 2
Figure 2
Cost drivers mapped to the nutrition‐sensitive value chain typology for the TRAIN intervention in Bangladesh (Source: Authors). TRAIN, Targeting and Realigning Agriculture to Improve Nutrition.
Figure 3
Figure 3
Tornado plot from the sensitivity analysis for total incremental costs
See this image and copyright information in PMC

References

    1. Amin, S. , Rai, A. S. , & Topa, G. (2003). Does microcredit reach the poor and vulnerable? evidence from Northern Bangladesh. Journal of Development Economics, 70(1), 59–82.
    1. Banerjee, A. , Karlan, D. , & Zinman, J. (2015). Six randomized evaluations of microcredit: Introduction and further steps. American Economic Journal: Applied Economics, 7(1), 1–21.
    1. Brauw, A. , Eozenou, P. , Gilligan, D. O. , Hotz, C. , Kumar, N. , & Meenakshi, J. V. (2018). Biofortification, crop adoption and health information: Impact pathways in Mozambique and Uganda. American Journal of Agricultural Economics, 100(3), 906–930. - PMC - PubMed
    1. Brooker, S. , Kabatereine, N. B. , Fleming, F. , & Devlin, N. (2007). Cost and cost‐effectiveness of nationwide school‐based helminth control in Uganda: Intra‐country variation and effects of scaling‐up. Health Policy and Planning, 23(1), 24–35. - PMC - PubMed
    1. De la Pena, I. , Garrett, J. , & Gelli, A. (2020). Nutrition‐sensitive Value Chains from a Smallholder Perspective: A Framework for Project Design. International Fund for Agricultural Development (IFAD).

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