Modelling the potential cost-effectiveness of food-based programs to reduce malnutrition

Poor quality diets contribute to malnutrition globally, but evidence is weak on the cost-effectiveness of food-based interventions that shift diets. This study assessed 11 candidate interventions developed through Delphi techniques to improve diets in India, Nigeria, and Ethiopia. A Markov simulation model incorporated time, individual-level, nutrition, and policy parameters to estimate health impacts and cost-effectiveness for reducing stunting, anaemia, diarrhea, and mortality in preschool children. At an assumed 80% coverage, interventions considered would potentially save between 0·16 and 3·20 years of life per child. The average cost-effectiveness ratio ranged from US$9 to US$2000 per life year saved. This approach, linking expert knowledge, known costs, and modelling, offers potential for estimating cost-effective investments for better informed policy choice where empirical evidence is limited.
Highlights • Few studies estimate the potential cost-effectiveness of programs for improving health through diets. • Expert knowledge linked to modelling offers a basis for assessing potential alternatives where data are lacking. • Our analysis assessed 11 candidate interventions for Ethiopia, India, and Nigeria derived from local expert opinion. • Modelling demonstrates these programs' potential health impacts and cost-effectiveness. • The modelling of estimated benefits can support best-buy policy and program choices.