“Estimating the Incalculable”: Economic Evaluation of a multi-sectoral nutrition program in Nepal

Abstract

Malnutrition remains a significant cause of death and disability for children in low-income countries. To address this, multi-sectoral interventions have shown potential. However, there is a lack of economic evaluations for such programs. This study aimed to assess the cost-effectiveness and benefit-cost analysis of a multi-sectoral nutrition intervention in Nepal. We used costing estimates of the Suaahara II program from SEEMS-Nutrition group at University of Washington. We measured program outcomes in terms of prevented premature deaths, reduced stunting cases, and reduced diarrhea incidence using the Lived Saved Tool (LiST). We evaluated the benefits by estimating averted DALYs (disability-adjusted life years) and the value resulting from lowered premature mortality, increased lifetime productivity, and reduced non-fatal health risks. We estimated cost-effectiveness ratio at $24,352 per DALY averted assuming standard life expectancy. We estimated the benefit-cost ratio at 1.93-1.95. In conclusion, although the program is not cost-effective, it could still be considered a good investment as the benefit-cost analysis confirmed that the program yielded a positive return on investment.