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Transcript of World bank meera shekar
MQSUN
Stocktaking
Planning, Costing and FinancingCommunity of Practice
FAO
WHO
FANTA
World Bank
Questions
Strictly Confidential © 2014
Scaling Up Nutrition: What Will it Cost at the Country Level? World
Bank Group TA to SUN Member Countries
Dr. Meera Shekar
Lead Health and Nutrition Specialist
World Bank Group
Countries Planned or in Progress
Countries in Progress: • Nigeria• DRC• Uganda• Zambia• Mali• Togo• Niger
Countries Planned:
• Tanzania• Kenya• Madagascar• Cote De Ivoire• Burundi• Others TBD
3
Examples of Nutrition-Specific Interventions
Micronutrient Supplementation
Deworming
Fortification of Staple Foods
Prevention/treatment of acute malnutrition (CMAM,
Public Provision of Complementary Foods)
Examples of Nutrition-Sensitive Interventions
Agriculture (e.g. Biofortification, Aflatoxin
Control)
Education (e.g. Hygiene promotion, school-based
deworming)
WASH
Social Protection (e.g. CCTs)
Step 1: Consultations with government and partners to identify nutrition-specific interventions and to explore potential nutrition-sensitive interventions
Step 2: Data Collection (Coverage rates and unit costs)
Step 3: Costing Calculations (Cost of scaling up interventions from current coverage rates)
Step 4: Benefit Calculations (DALYs saved, Lives saved, Cases of stunting averted, Return on investment)
Step 5: Cost-effectiveness analysis, elaboration of scale-up scenarios for prioritizing resource allocation, and capacity building for government officials
Methods
4
5
Scenarios Annual Public Investment
(US$ million)
# DALYs Saved
(cost/DALY saved)
# LivesSaved
(cost/life saved)
# Cases of Stunting Averted(cost/case averted)
A) All Interventions Scaled to Full National Coverage
$840 15,269,856($55)
248,997 ($3,584)
1,786,291 ($469)
B) Micronutrients, deworming, CNPs and CMAM at “full coverage” in states with >25% stunting
$337 10,513,601($32.1)
131,093($2,817)
1,187,304($284)
C) Micronutrients, deworming, CNPs and CMAM at full coverage in states with >35% stunting
$271 8,426,707($32.2)
96,686($2,806)
889,322($305)
D) All interventions in all states at “partial coverage” rates
$353 7,892,586($44.7)
127,774($2,763)
889,657($417)
E) Micronutrients & Deworming in all states plus CMAM and CNPs at in 13 high burden states (partial coverage)
$184 4,598,018($39.3)
70,305($2,612)
405,926($453)
F) Micronutrients & Deworming in all states (partial coverage) plus CMAM and CNPs in 13 high burden states (full coverage)
$328 7,705,748($42.5)
112,591($2,911)
712,736($460)
Example of Results: Nigeria
School-based Deworming
$2.4 million annually
$4.55/DALY saved
Biofortification of Cassava
$25 million total
800,000 DALYs saved
$7.90-$137.40/DALY
saved
School-based Promotion of Good Hygiene
$59.5 million annually
Aflatoxin Reduction through
Biocontrol
$65.4 annually
1,537,790 DALYs saved
$43/DALY saved