Economic Evaluation of Nutrition-Sensitive Agricultural Interventions to Increase Maternal and Child Dietary Diversity and Nutritional Status in Rural Odisha, India.

Content Provider	Europe PMC
Author	Haghparast-Bidgoli, Hassan Harris-Fry, Helen Kumar, Abhinav Pradhan, Ronali Mishra, Naba Kishore Padhan, Shibananth Ojha, Amit Kumar Mishra, Sailendra Narayan Fivian, Emily James, Philip Ferguson, Sarah Krishnan, Sneha O'Hearn, Meghan Palmer, Tom Koniz-Booher, Peggy Danton, Heather Minovi, Sandee Mohanty, Satyanarayan Rath, Shibanand Rath, Suchitra Nair, Nirmala Tripathy, Prasanta Prost, Audrey Allen, Elizabeth Skordis, Jolene Kadiyala, Suneetha
Copyright Year	2022
Abstract	ABSTRACTBackgroundEconomic evaluations of nutrition-sensitive agriculture (NSA) interventions are scarce, limiting assessment of their potential affordability and scalability.ObjectivesWe 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.MethodsInterventions 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$.ResultsTotal 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.ConclusionNSA 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.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC9535442&blobtype=pdf
Page Count	14
ISSN	00223166
Journal	The Journal of Nutrition [J Nutr]
Volume Number	152
DOI	10.1093/jn/nxac132
PubMed Central reference number	PMC9535442
Issue Number	10
PubMed reference number	35687367
e-ISSN	15416100
Language	English
Publisher	Oxford University Press
Publisher Date	2022-10-01
Access Restriction	Open
Rights License	This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. © The Author(s) 2022. Published by Oxford University Press on behalf of the American Society for Nutrition.
Subject Keyword	Nutrition-sensitive agriculture Cost–consequence analysis Participatory learning and action Women's groups Dietary diversity Maternal and child nutrition India
Content Type	Text
Resource Type	Article
Subject	Nutrition and Dietetics Medicine