The costs and effectiveness of three vitamin A interventions in Guatemala

• Published in: Social science & medicine (1982) Vol. 42; no. 12; pp. 1661 - 1668
• Main Authors: Phillips, Margaret, Sanghvi, Tina, Suárez, Ruben, McKigney, John, Fiedler, John
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.06.1996; Elsevier; Pergamon Press Inc
• Series: Social Science & Medicine
• Subjects: Biological and medical sciences; Cost effectiveness; Cost-Benefit Analysis; Costs; Developing countries; Diet Surveys; Food, Fortified - economics; General populations; Guatemala; Health; Health Education - economics; Health Promotion - economics; Humans; Medical sciences; Nutrition; Nutrition education; Nutritional Physiological Phenomena; Prevention and actions; programs; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Tropical medicine; Vitamin A; Vitamin A - economics; Vitamin A - therapeutic use; Vitamin A Deficiency - drug therapy; Vitamin A Deficiency - economics; Vitamin A Deficiency - therapy; vitamin A programs cost-effectiveness; Vitamin A supplement; Guatemala; Central America; America; cost-effectiveness; vitamin A; programs; Sanitary program; Nutrition education; Nutrition; Deficiency; Vitamin; Retinol; Prevention; Chemotherapy; Treatment; Health economy; Complementation; Comparative study; Public health; Cost efficiency analysis
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/0277-9536(95)00317-7

The purpose of the study presented in this paper was to estimate, using secondary sources of data, the cost and effectiveness of three programs to combat vitamin A deficiency in Guatemala—the national sugar fortification program, a targeted capsules distribution program and the promotion of home food production combined with nutrition education—and to draw conclusions concerning priorities for Guatemala. Data on the costs and coverage were collected from implementing agencies in Guatemala. Coverage data were converted into a common set of impact indicators. Sensitivity analyses were conducted on variables whose precise value was uncertain. Potential impacts of improvements in program performance operations were also explored. The analysis found the cost per high-risk person achieving adequate vitamin A to be US$ 0.98 for fortification, US$ 1.68–1.86 for capsule distribution and US$ 3.10–4.16 for food production/education. Fortification is the most efficient option if vitamin A levels in sugar are maintained at reasonable levels. Where fortified sugar is not consumed and vitamin A deficiency is highly prevalent, small-scale, targeted, complementary interventions such as capsules and food production/education may be appropriate for sustained/broader impacts.