Using Cost-Effectiveness Analysis to Evaluate Targeting Strategies
The Case of Vitamin A Supplementation
Bibliographic Data
| ID | 11491397 |
|---|---|
| Authors | B P Loevinsohn, Benjamin Loevinsohn (0009-0007-7075-5723, Asian Development Bank, corresponding author), Roland W Sutter (0000-0003-2630-1699, Centers for Disease Control and Prevention), M Otelia Costales (Department of Health) |
| Year | 1997 |
| Volume | 12 |
| Issue | 1 |
| Pages | 29-37 |
| Publication date | 1997-01-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Health Policy and Planning (JOURNAL) |
| Journal identifiers | ISSN: 0268-1080 • E-ISSN: 1460-2237 |
| Publisher | Oxford University Press (PUBLISHER • GB) |
| DOI | 10.1093/heapol/12.1.29 |
| PMID | 10166100 |
| OpenAlex | W2107190133 |
| Language | EN |
| Citations received | 3 |
Given the demonstrated efficacy of vitamin A supplements in reducing childhood mortality, health officials now have to decide whether it would be efficient to target the supplements to high risk children. Decisions about targeting are complex because they depend on a number of factors; the degree of clustering of preventable deaths, the cost of the intervention, the side-effects of the intervention, the cost of identifying the high risk group, and the accuracy of the 'diagnosis' of risk. A cost-effectiveness analysis was used in the Philippines to examine whether vitamin A supplements should be given universally to all children 6-59 months, targeted broadly to children suffering from mild, moderate, or severe malnutrition, or targeted narrowly to pre-schoolers with moderate and severe malnutrition. The first year average cost of the universal approach was US$67.21 per death averted compared to $144.12 and $257.20 for the broad and narrow targeting approaches respectively. When subjected to sensitivity analysis the conclusion about the most cost-effective strategy was robust to changes in underlying assumptions such as the efficacy of supplements, clustering of deaths, and toxicity. Targeting vitamin A supplements to high risk children is not an efficient use of resources. Based on the results of this cost-effectiveness analysis and a consideration of alternate strategies, it is apparent that vitamin A, like immunization, should be provided to all pre-schoolers in the developing world. Issues about targeting public health interventions can usefully be addressed by cost-effectiveness analysis.
Cost effectiveness · Cost-effectiveness analysis · Cost–benefit analysis · Developing country · Economic growth · Environmental health · Intensive care medicine · Intervention (counseling) · Malnutrition · Psychological intervention · Public health · Risk analysis (engineering) · Vitamin · Vitamin A deficiency · Child Nutrition and Water Access · Internal Medicine · Medicine · Nursing · Pediatrics
| Citations per year | 0.12 |
|---|---|
| Citation span | 2000 - 2019 (20) |
| Highly cited | No |