An Investment Framework for Nutrition in Afghanistan : Estimating the Costs, Impacts, and Cost-Effectiveness of Expanding High-Impact Nutrition Interventions to Reduce Stunting in the Early Years
This paper examines the costs, impacts, and cost-effectiveness of scaling up over five years the nutrition interventions included in Afghanistan’s Basic Package of Health Services (BPHS) as a first step in investing in the early years to build huma...
| Main Authors: | , , , , , , , , |
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| Format: | Working Paper |
| Language: | English |
| Published: |
World Bank, Washington, DC
2018
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| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/785471534270746882/An-investment-framework-for-nutrition-in-Afghanistan-estimating-the-costs-impacts-and-cost-effectiveness-of-expanding-high-impact-nutrition-interventions-to-reduce-stunting-and-invest-in-the-early-years http://hdl.handle.net/10986/30313 |
| Summary: | This paper examines the costs, impacts,
and cost-effectiveness of scaling up over five years the
nutrition interventions included in Afghanistan’s Basic
Package of Health Services (BPHS) as a first step in
investing in the early years to build human capital. The
total public investment required for the scale up to
government-set program coverage levels is estimated to be 44
million US dollars per year over five years, or 1.49 US
dollars per capita per year. Each dollar invested would
yield at least 13 US dollars in economic returns and even
under conservative assumptions regarding future economic
growth, the economic benefits exceed the cost by six times
which is 815 million US dollars over the productive lives of
the beneficiaries. This scale up would prevent almost 25,000
child deaths and over 4,000 cases of stunting and avert a
loss of 640,000 disability-adjusted life years (DALYs) and
almost 90,000 cases years of anemia. Almost 100,000 more
children would be exclusively breastfed. However, this
scale-up would only have a marginal effect, a decrease of
less than one-half percentage point on stunting prevalence
because the current government-set target program coverage
rates are very low for the preventive interventions that
affect stunting. A substantially greater impact could be
achieved if preventive interventions could be scaled to full
program coverage levels, which would require less than 5
million US dollars more a year. This would triple the number
of DALYs averted, double the number of deaths averted and
avert almost eight times as many cases of stunting,
resulting in a 2.6 percentage point decline in stunting over
the five year period (from 41 percent to 38 percent). The
prevalence of anemia in pregnant women could be reduced by
12 percentage points and the prevalence of exclusive
breastfeeding could be increased by 18 percentage points. In
addition, this investment is projected to generate economic
benefits of 815 million US dollars over the productive lives
of the beneficiaries. Each dollar invested would yield more
than 13 US dollars in economic returns. Sensitivity analysis
was conducted for the total cost, cost-effectiveness, and
economic returns on investing in the BPHS nutrition interventions. |
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