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Economic evaluation of nutrition-sensitive agricultural interventions to increase maternal and child dietary diversity and nutritional status in rural Odisha, India

Haghparast-Bidgoli, Hassan; Harris-Fry, Helen; Kumar, Abhinav; Pradhan, Ronali; Mishra, Naba Kishore; Padhan, Shibananth; Ojha, Amit Kumar; ... Kadiyala, Suneetha; + view all (2022) Economic evaluation of nutrition-sensitive agricultural interventions to increase maternal and child dietary diversity and nutritional status in rural Odisha, India. The Journal of Nutrition , 152 (10) pp. 2255-2268. 10.1093/jn/nxac132. Green open access

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Abstract

BACKGROUND: Economic evaluations of nutrition-sensitive agriculture (NSA) interventions are scarce, limiting assessment of their potential affordability and scalability. OBJECTIVES: We conducted cost–consequence analyses of 3 participatory video-based interventions of fortnightly women’s group meetings using the following platforms: 1) NSA videos; 2) NSA and nutrition-specific videos; or 3) NSA videos with a nutrition-specific participatory learning and action (PLA) cycle. METHODS: Interventions were tested in a 32-mo, 4-arm cluster-randomized controlled trial, Upscaling Participatory Action and Videos for Agriculture and Nutrition (UPAVAN) in the Keonjhar district, Odisha, India. Impacts were evaluated in children aged 0–23 mo and their mothers. We estimated program costs using data collected prospectively from expenditure records of implementing and technical partners and societal costs using expenditure assessment data collected from households with a child aged 0–23 mo and key informant interviews. Costs were adjusted for inflation, discounted, and converted to 2019 US$. RESULTS: Total program costs of each intervention ranged from US$272,121 to US$386,907. Program costs per pregnant woman or mother of a child aged 0–23 mo were US$62 for NSA videos, US$84 for NSA and nutrition-specific videos, and US$78 for NSA videos with PLA (societal costs: US$125, US$143, and US$122, respectively). Substantial shares of total costs were attributable to development and delivery of the videos and PLA (52–69%) and quality assurance (25–41%). Relative to control, minimum dietary diversity was higher in the children who underwent the interventions incorporating nutrition-specific videos and PLA (adjusted RRs: 1.19 and 1.27; 95% CIs: 1.03–1.37 and 1.11, 1.46, respectively). Relative to control, minimum dietary diversity in mothers was higher in those who underwent NSA video (1.21 [1.01, 1.45]) and NSA with PLA (1.30 [1.10, 1.53]) interventions. CONCLUSIONS: NSA videos with PLA can increase both maternal and child dietary diversity and have the lowest cost per unit increase in diet diversity. Building on investments made in developing UPAVAN, cost-efficiency at scale could be increased with less intensive monitoring, reduced startup costs, and integration within existing government programs. This trial was registered at clinicaltrials.gov as ISRCTN65922679.

Type: Article
Title: Economic evaluation of nutrition-sensitive agricultural interventions to increase maternal and child dietary diversity and nutritional status in rural Odisha, India
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/jn/nxac132
Publisher version: https://doi.org/10.1093/jn/nxac132
Language: English
Additional information: © The Author(s) 2022. Published by Oxford University Press on behalf of the American Society for Nutrition. This is an Open Access e distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/).
Keywords: Nutrition-sensitive agriculture, Cost–consequence analysis, Participatory learning and action, Women’s groups, Dietary diversity, Maternal and child nutritionIndia
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10150261
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