Abstract
BackgroundMicronutrient deficiencies (MNDs) are a chronic lack of vitamins and minerals and constitute a huge public health problem. MNDs have severe health consequences and are particularly harmful during early childhood due to their impact on the physical and cognitive development. We estimate the costs of illness due to iron deficiency (IDA), vitamin A deficiency (VAD) and zinc deficiency (ZnD) in 2 age groups (6–23 and 24–59 months) of Filipino children by socio-economic strata in 2008.MethodsWe build a health economic model simulating the consequences of MNDs in childhood over the entire lifetime. The model is based on a health survey and a nutrition survey carried out in 2008. The sample populations are first structured into 10 socio-economic strata (SES) and 2 age groups. Health consequences of MNDs are modelled based on information extracted from literature. Direct medical costs, production losses and intangible costs are computed and long term costs are discounted to present value.ResultsTotal lifetime costs of IDA, VAD and ZnD amounted to direct medical costs of 30 million dollars, production losses of 618 million dollars and intangible costs of 122,138 disability adjusted life years (DALYs). These costs can be interpreted as the lifetime costs of a 1-year cohort affected by MNDs between the age of 6–59 months. Direct medical costs are dominated by costs due to ZnD (89% of total), production losses by losses in future lifetime (90% of total) and intangible costs by premature death (47% of total DALY losses) and losses in future lifetime (43%). Costs of MNDs differ considerably between SES as costs in the poorest third of the households are 5 times higher than in the wealthiest third.ConclusionsMNDs lead to substantial costs in 6-59-month-old children in the Philippines. Costs are highly concentrated in the lower SES and in children 6–23 months old. These results may have important implications for the design, evaluation and choice of the most effective and cost-effective policies aimed at the reduction of MNDs.
Highlights
Micronutrient deficiencies (MNDs) are a chronic lack of vitamins and minerals and constitute a huge public health problem
Model Population The model population consists of all Filipino children aged 6–59 months stratified by 10 socio-economic strata (SES) and 2 age groups
Without discounting Disability adjusted life year (DALY) lost in future lifetime due to impaired development and premature death would increase by 138% and total DALYs by 125%
Summary
Micronutrient deficiencies (MNDs) are a chronic lack of vitamins and minerals and constitute a huge public health problem. MNDs are sometimes called hidden hunger, as they are not as visible as malnutrition due to insufficient calorie and protein intake They have severe health consequences and are harmful during pregnancy and early childhood due to their impact on the physical and cognitive development of children [5,6]. Studies evaluating the impact of a disease are called “cost-of-illness studies” when they focus on its economic costs in terms of medical costs and productivity losses and “burden-of-disease studies” when they focus on its human costs in terms of years lived with disability and years of life lost These studies are often carried out in order to draw the attention of policy makers to the impact of specific diseases and can be of utmost importance for public health priority setting. UN development agencies and NGOs have rated interventions focussing on MNDs as a top development priority and these interventions are part of the efforts to reach the United Nations Millennium Development Goals [16,17]
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