Measurement of Benefits in Economic Analyses of Nutrition-Specific and -Sensitive Programs: A Systematic Review

Abstract

Abstract Objectives Improved methods for measuring and valuing the full range of benefits for multi-sector nutrition programs is needed to demonstrate their overall impact and strengthen use of economic evaluation evidence. The objective of this study was to identify and characterize the range of benefits measured in economic evaluations of nutrition programs. Methods A systematic review was conducted of peer-reviewed cost-benefit, -effectiveness, or -utility studies of nutrition programs in low- and middle-income countries from 2010 and after. The nutrition interventions searched for were selected from the Scaling Up Nutrition United Nations Network's Compendium of Actions for Nutrition and categorized into four sectors (food/agriculture, health, social protection, and water/sanitation) to identify variation across disciplines. For each study, two reviewers assessed the types of economic analysis and benefits included in the comparison of costs and outcomes. Results A total of 64 studies comparing costs and benefits were identified. These studies assessed 39 types of nutrition interventions (out of 79 considered), and most commonly were within the health sector (45%), followed by food/agriculture (27%). Eight studies (13%) assessed programs across more than one sector. 38% of the studies conducted cost-utility analyses (calculated cost per disability- or quality-adjusted life year), 58% calculated cost-effectiveness (cost per any other outcome), and 34% calculated cost-benefit analyses (converted all benefits to monetary values to compare with program costs). In terms of types of benefits measured, the majority of studies focused on nutrition disorders and associated morbidity as their main outcome, while food consumption and other nutrition-related practices were relatively rare (less than 5%). Several studies included cost savings from improved nutrition, including both direct costs (e.g., health system and out-of-pocket costs for treating nutrition disorders) and indirect costs (lost productive time due to illness). Conclusions Economic evaluations do not yet exist for a wide range of recommended nutrition actions, and future research should work to address these gaps. In doing so, special consideration should be given to incorporating benefits beyond reduction of nutrition disorders. Funding Sources Bill and Melinda Gates Foundation.