Societal Costs of Micronutrient Deficiencies in 6- to 59-month-old Children in Pakistan.
- Wieser S 1 Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland.
- Brunner B 1 Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland.
- Tzogiou C 1 Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland.
- Plessow R 1 Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland.
- Zimmermann MB 2 Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland.
- Farebrother J 2 Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland.
- Soofi S 3 Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan.
- Bhatti Z 3 Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan.
- Ahmed I 3 Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan.
- Bhutta ZA 3 Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan.
- 2017-10-04
Published in:
- Food and nutrition bulletin. - 2017
Pakistan
child nutrition
cost analysis
disability-adjusted life-years (DALYs)
economic status
micronutrient deficiency
Child, Preschool
Cost of Illness
Costs and Cost Analysis
Deficiency Diseases
Female
Humans
Infant
Infant Nutrition Disorders
Male
Micronutrients
Models, Economic
Pakistan
Poverty
Quality-Adjusted Life Years
Socioeconomic Factors
English
BACKGROUND
In Pakistan, nearly half of children younger than 5 years are stunted, and 1 in 3 is underweight. Micronutrient deficiencies, a less visible form of undernutrition, are also endemic. They may lead to increased morbidity and mortality as well as to impaired cognitive and physical development.
OBJECTIVE
To estimate the lifetime costs of micronutrient deficiencies in Pakistani children aged between 6 and 59 months.
METHODS
We develop a health economic model of the lifetime health and cost consequences of iodine, iron, vitamin A, and zinc deficiencies. We assess medical costs, production losses in terms of future incomes lost, and disability-adjusted life-years (DALYs). The estimation is based on large population surveys, information on the health consequences of micronutrient deficiencies extracted from randomized trials, and a variety of other sources.
RESULTS
Total societal costs amount to US$46 million in medical costs, US$3,222 million in production losses, and 3.4 million DALYs. Costs are dominated by the impaired cognitive development induced by iron-deficiency anemia in 6- to 23-month-old children and the mortality caused by vitamin A deficiency. Costs are substantially higher in poorer households.
CONCLUSIONS
Societal costs amounted to 1.44% of gross domestic product and 4.45% of DALYs in Pakistan in 2013. These costs hinder the country's development. They could be eliminated by improved nutrition of 6- to 59-month-old children and public health measures. Our results may contribute to the design of cost-effective interventions aiming to reduce micronutrient deficiencies in early childhood and their lifetime consequences.
In Pakistan, nearly half of children younger than 5 years are stunted, and 1 in 3 is underweight. Micronutrient deficiencies, a less visible form of undernutrition, are also endemic. They may lead to increased morbidity and mortality as well as to impaired cognitive and physical development.
OBJECTIVE
To estimate the lifetime costs of micronutrient deficiencies in Pakistani children aged between 6 and 59 months.
METHODS
We develop a health economic model of the lifetime health and cost consequences of iodine, iron, vitamin A, and zinc deficiencies. We assess medical costs, production losses in terms of future incomes lost, and disability-adjusted life-years (DALYs). The estimation is based on large population surveys, information on the health consequences of micronutrient deficiencies extracted from randomized trials, and a variety of other sources.
RESULTS
Total societal costs amount to US$46 million in medical costs, US$3,222 million in production losses, and 3.4 million DALYs. Costs are dominated by the impaired cognitive development induced by iron-deficiency anemia in 6- to 23-month-old children and the mortality caused by vitamin A deficiency. Costs are substantially higher in poorer households.
CONCLUSIONS
Societal costs amounted to 1.44% of gross domestic product and 4.45% of DALYs in Pakistan in 2013. These costs hinder the country's development. They could be eliminated by improved nutrition of 6- to 59-month-old children and public health measures. Our results may contribute to the design of cost-effective interventions aiming to reduce micronutrient deficiencies in early childhood and their lifetime consequences.
- Language
-
- English
- Open access status
- hybrid
- Identifiers
-
- DOI 10.1177/0379572117720012
- PMID 28969507
- Persistent URL
- https://folia.unifr.ch/global/documents/238710
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