An Investment Framework for Nutrition in Zambia : Reducing Stunting and Other Forms of Child Malnutrition

This paper builds on global experience and Zambia's specific context to identify aneffective nutrition approach along with costs and benefits of key nutrition interventions. It isintended to help guide the selection of the most cost-effective...

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Main Authors: Dayton Eberwein, Julia, Kakietek, Jakub, Shekar, Meera, Subandoro, Ali, Pereira, Audrey, Hyder, Zia, Sunkutu, Rosemary, Akuoku, Jonathan Kweku
Format: Working Paper
Language:English
en_US
Published: World Bank, Washington, DC 2017
Subjects:
Online Access:http://documents.worldbank.org/curated/en/652911506528094122/An-investment-framework-for-nutrition-in-Zambia-reducing-stunting-and-other-forms-of-child-malnutrition
http://hdl.handle.net/10986/28496
id okr-10986-28496
recordtype oai_dc
spelling okr-10986-284962021-05-25T09:53:43Z An Investment Framework for Nutrition in Zambia : Reducing Stunting and Other Forms of Child Malnutrition Dayton Eberwein, Julia Kakietek, Jakub Shekar, Meera Subandoro, Ali Pereira, Audrey Hyder, Zia Sunkutu, Rosemary Akuoku, Jonathan Kweku NUTRITION HEALTH FINANCE AGRICULTURE EDUCATION This paper builds on global experience and Zambia's specific context to identify aneffective nutrition approach along with costs and benefits of key nutrition interventions. It isintended to help guide the selection of the most cost-effective interventions as well as strategiesfor scaling these up. The paper considers both relevant "nutrition-specific" interventions, largelydelivered through the health sector, and multisectoral "nutrition-sensitive" interventions, delivered through other sectors such as agriculture, education, and water and sanitation. We estimate that the costs and benefits of implementing 10 nutrition-specific interventions would require an annual public investment of $40.5 million and would avert over 112,000 DALYs, save over 2,800 lives, and prevent 62,000 cases of stunting. Economic productivity could potentially increase by $915 million annually over the productive lives of the beneficiaries, with an impressive internal rate of return of 32 percent. However, because it is unlikely that the Government of the Zambia or its partners will find the $40.5 million necessary each year to reach full coverage, we also consider scale-up scenarios based on considerations of their potential for impact, burden of stunting, resource requirements, and implementation capacity. The two scenarios that scale up the nine most cost-effective nutrition-specific interventions (excluding the public provision of complementary foods) are the most advantageous in terms of cost-effectiveness and resource requirements and would require $11 million to scale up to partial levels and $23 to scale up to full coverage levels. Among the 8 nutrition-specific interventions we consider, school-baseddeworming is low cost and effective. The interventions we reviewed in the agriculture sector areexpensive when compared to nutrition-specific interventions, although very little cost effectiveness data are available for the nutrition-sensitive interventions to make carefulcomparisons. These findings point to a powerful set of nutrition-specific interventions and acandidate list of nutrition-sensitive approaches that represent a highly cost-effective approach toreducing child malnutrition in Zambia. 2017-10-11T15:47:39Z 2017-10-11T15:47:39Z 2016-11 Working Paper http://documents.worldbank.org/curated/en/652911506528094122/An-investment-framework-for-nutrition-in-Zambia-reducing-stunting-and-other-forms-of-child-malnutrition http://hdl.handle.net/10986/28496 English en_US Health, Nutrition and Population Discussion Paper; CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank World Bank, Washington, DC Publications & Research Publications & Research :: Working Paper Africa Zambia
repository_type Digital Repository
institution_category Foreign Institution
institution Digital Repositories
building World Bank Open Knowledge Repository
collection World Bank
language English
en_US
topic NUTRITION
HEALTH FINANCE
AGRICULTURE
EDUCATION
spellingShingle NUTRITION
HEALTH FINANCE
AGRICULTURE
EDUCATION
Dayton Eberwein, Julia
Kakietek, Jakub
Shekar, Meera
Subandoro, Ali
Pereira, Audrey
Hyder, Zia
Sunkutu, Rosemary
Akuoku, Jonathan Kweku
An Investment Framework for Nutrition in Zambia : Reducing Stunting and Other Forms of Child Malnutrition
geographic_facet Africa
Zambia
relation Health, Nutrition and Population Discussion Paper;
description This paper builds on global experience and Zambia's specific context to identify aneffective nutrition approach along with costs and benefits of key nutrition interventions. It isintended to help guide the selection of the most cost-effective interventions as well as strategiesfor scaling these up. The paper considers both relevant "nutrition-specific" interventions, largelydelivered through the health sector, and multisectoral "nutrition-sensitive" interventions, delivered through other sectors such as agriculture, education, and water and sanitation. We estimate that the costs and benefits of implementing 10 nutrition-specific interventions would require an annual public investment of $40.5 million and would avert over 112,000 DALYs, save over 2,800 lives, and prevent 62,000 cases of stunting. Economic productivity could potentially increase by $915 million annually over the productive lives of the beneficiaries, with an impressive internal rate of return of 32 percent. However, because it is unlikely that the Government of the Zambia or its partners will find the $40.5 million necessary each year to reach full coverage, we also consider scale-up scenarios based on considerations of their potential for impact, burden of stunting, resource requirements, and implementation capacity. The two scenarios that scale up the nine most cost-effective nutrition-specific interventions (excluding the public provision of complementary foods) are the most advantageous in terms of cost-effectiveness and resource requirements and would require $11 million to scale up to partial levels and $23 to scale up to full coverage levels. Among the 8 nutrition-specific interventions we consider, school-baseddeworming is low cost and effective. The interventions we reviewed in the agriculture sector areexpensive when compared to nutrition-specific interventions, although very little cost effectiveness data are available for the nutrition-sensitive interventions to make carefulcomparisons. These findings point to a powerful set of nutrition-specific interventions and acandidate list of nutrition-sensitive approaches that represent a highly cost-effective approach toreducing child malnutrition in Zambia.
format Working Paper
author Dayton Eberwein, Julia
Kakietek, Jakub
Shekar, Meera
Subandoro, Ali
Pereira, Audrey
Hyder, Zia
Sunkutu, Rosemary
Akuoku, Jonathan Kweku
author_facet Dayton Eberwein, Julia
Kakietek, Jakub
Shekar, Meera
Subandoro, Ali
Pereira, Audrey
Hyder, Zia
Sunkutu, Rosemary
Akuoku, Jonathan Kweku
author_sort Dayton Eberwein, Julia
title An Investment Framework for Nutrition in Zambia : Reducing Stunting and Other Forms of Child Malnutrition
title_short An Investment Framework for Nutrition in Zambia : Reducing Stunting and Other Forms of Child Malnutrition
title_full An Investment Framework for Nutrition in Zambia : Reducing Stunting and Other Forms of Child Malnutrition
title_fullStr An Investment Framework for Nutrition in Zambia : Reducing Stunting and Other Forms of Child Malnutrition
title_full_unstemmed An Investment Framework for Nutrition in Zambia : Reducing Stunting and Other Forms of Child Malnutrition
title_sort investment framework for nutrition in zambia : reducing stunting and other forms of child malnutrition
publisher World Bank, Washington, DC
publishDate 2017
url http://documents.worldbank.org/curated/en/652911506528094122/An-investment-framework-for-nutrition-in-Zambia-reducing-stunting-and-other-forms-of-child-malnutrition
http://hdl.handle.net/10986/28496
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