Economic returns on investing in early childhood development in Vietnam: a cost-benefit analysis

• Published in: BMC health services research Vol. 25; no. 1; pp. 384 - 9
• Main Authors: Baek, Yeji, Fisher, Jane, Tran, Thach, Owen, Alice, Nguyen, Trang, Luchters, Stanley, Hipgrave, David B., Hanieh, Sarah, Tran, Tuan, Ha, Tran-Thi-Thu, Biggs, Beverley-Ann, Ademi, Zanfina
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 15.03.2025; BioMed Central; BMC
• Subjects: Adult; Age groups; Babies; Child; Child Development; Child Health Services - economics; Child, Preschool; Children & youth; Clinical trials; Cognitive development; Comparative analysis; Cost analysis; Cost benefit analysis; Decision making; Early childhood development; Early childhood education; Economic aspects; Employment; Families & family life; Female; GDP; Gross Domestic Product; Humans; Infant; Infant, Newborn; Intervention; Investments; Labor force; Language Development; Learning; Male; Maternal-Child Health Services - economics; Methods; Motor Activity; Parent training; Population; Postpartum period; Salaries and Fringe Benefits - statistics & numerical data; Social aspects; Standard of care; Vietnam; Wages; Wages & salaries; Womens health; Vietnam; Kenya; Colombia; Nicaragua; United States > US; Cost-benefit analysis; Vietnam; Early childhood development
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-025-12516-z

Economic evidence on the long-term benefits of investing in early childhood development is limited. This study aimed to estimate the potential long-term economic benefits of an early childhood development intervention 'Learning Clubs' in Vietnam. We conducted a cost-benefit analysis to estimate the costs and benefits of the intervention compared to the standard of care from a limited societal perspective. The intervention cost and child cognitive development outcome were derived from the published 'Learning Clubs' trial-based cost-effectiveness analysis. Benefits were monetised based on the gains in wages associated with improved cognitive development over a lifetime at the population level, using a life-table model. The benefit-cost ratio was estimated as the benefits in wages divided by the intervention cost with a 3% discount rate, assuming nationwide scale up to a hypothetical national birth cohort. Sensitivity, scenario, and threshold analyses were conducted to examine the uncertainty around the model. The benefit-cost ratio was 5.52, indicating that the expected benefit for each US$1 invested would be US$5.52. The intervention would generate economic benefits of US$1,566 per child over their lifetime. Upon nationwide scale-up, the total benefit would amount to US$2.28 billion per national annual birth cohort. Probabilistic sensitivity analyses estimated the benefit-cost ratio to be 5.90 (95%CI 2.66 to 11.12). The findings were relatively robust as the benefit-cost ratios remained above 1 in all sensitivity and scenario analyses. Our findings support greater investments in early childhood development. The Excel-based model is available for further use and adaption to other settings.