Cost effectiveness analysis of strategies for child health in developing countries.
OBJECTIVE
To determine the costs and effectiveness of selected child health interventions-namely, case management of pneumonia, oral rehydration therapy, supplementation or fortification of staple foods with vitamin A or zinc, provision of supplementary food with counselling on nutrition, and immunisation against measles.


METHODS
Cost effectiveness analysis.


METHODS
Efficacy data came from published systematic reviews and before and after evaluations of programmes. For resource inputs, quantities came from literature and expert opinion, and prices from the World Health Organization Choosing Interventions that are Cost Effective (WHO-CHOICE) database,


RESULTS
Cost effectiveness ratios clustered in three groups, with fortification with zinc or vitamin A as the most cost effective intervention, and provision of supplementary food and counselling on nutrition as the least cost effective. Between these were oral rehydration therapy, case management of pneumonia, vitamin A or zinc supplementation, and measles immunisation.


CONCLUSIONS
On the grounds of cost effectiveness, micronutrients and measles immunisation should be provided routinely to all children, in addition to oral rehydration therapy and case management of pneumonia for those who are sick. The challenge of malnutrition is not well addressed by existing interventions.
Edejer
Tessa Tan-Torres
TT
Costs, Effectiveness, Expenditure and Priority Setting, Health Systems Financing, World Health Organization, Geneva, Switzerland. tantorrest@who.int
Aikins
Moses
M
Black
Robert
R
Wolfson
Lara
L
Hutubessy
Raymond
R
Evans
David B
DB
D002648:Child; D002662:Child Health Services / Q000191:economics*; D003362:Cost-Benefit Analysis; D003376:Counseling; D003906:Developing Countries; D003967:Diarrhea / Q000517:prevention & control; D019587:Dietary Supplements / Q000191:economics; D005440:Fluid Therapy / Q000191:economics; D014943:Global Health; D006304:Health Status; D040361:Healthy People Programs / Q000191:economics*; D006801:Humans; D017589:Immunization Programs; D008457:Measles / Q000517:prevention & control; D009752:Nutritional Status; D011014:Pneumonia / Q000191:economics / Q000628:therapy; D014801:Vitamin A / Q000008:administration & dosage; D015032:Zinc / Q000008:administration & dosage
D014801:Vitamin A; D015032:Zinc