Cost effectiveness analysis of strategies for child health in developing countries

This article, published in the British Medical Journal, examines the costs and effectiveness of selected child health interventions: case management of pneumonia; oral rehydration therapy; supplementation or fortification of staple foods with vitamin A or zinc; provision of supplementary food with counselling on nutrition; and immunisation against measles. It finds that fortification with vitamin A or zinc was the most cost effective intervention, and provision of supplementary food and counselling on nutrition was the least cost effective.

The article concludes that, purely on cost effectiveness grounds, fortification or supplementation with vitamin A or zinc, treatment of pneumonia and diarrhoea, and measles immunisation should be pushed to their highest possible levels before supplementation of food along with nutrition counselling is provided. However, the authors also note that progress in the other Millennium Development Goals, such as the reduction of poverty and improvements in safe water, sanitation, and indoor air quality, will also impact on child health. They suggest that people interested in public health could also engage in inter-sectoral action to encourage these developments. Finally, they argue that there is an urgent health research agenda to find more effective and less costly ways of ensuring availability of food to young infants and children, in order to combat malnutrition.