title: Weekly iron-folic acid supplementation with regular deworming is cost-effective in preventing anaemia in women of reproductive age in Vietnam.
abstract: BACKGROUND
  To estimate the cost and cost-effectiveness of a project administering de-worming and weekly iron-folic acid supplementation to control anaemia in women of reproductive age in Yen Bai province, Vietnam.
  
  
  RESULTS
  Cost effectiveness was evaluated using data on programmatic costs based on two surveys in 2006 and 2009 and impact on anaemia and iron status collected in 2006, 2007, and 2008. Data on initial costs for training and educational materials were obtained from the records of the National Institute of Malariology, Parasitology and Entomology and the Yen Bai Malaria Control Program. Structured questionnaires for health workers at district, commune and village level were used to collect ongoing distribution and monitoring costs, and for participants to collect transport and loss of earnings costs. The cost per woman treated (defined as consuming at least 75% of the recommended intake) was USD0.76 per annum. This estimate includes financial costs (for supplies, training), and costs of health care workers' time. Prevalence of anaemia fell from 38% at baseline, to 20% after 12 months. Thus, the cost-effectiveness of the project is assessed at USD 4.24 per anaemia case prevented per year. Based on estimated productivity gains for adult women, the benefit:cost ratio is 6.7∶1. Cost of the supplements and anthelminthics was 47% of the total, while costs of training, monitoring, and health workers' time accounted for 53%.
  
  
  CONCLUSIONS
  The study shows that weekly iron-folic acid supplementation and regular de-worming is a low-cost and cost-effective intervention and would be appropriate for population-based introduction in settings with a high prevalence of anaemia and iron deficiency and low malaria infection rates.
authors.affiliation: Department of Medicine (RMH/WH), The University of Melbourne, The Royal Melbourne Hospital, Parkville, Australia.
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Casey
authors.forename: Davide
authors.initials: D
authors.lastname: Sartori
authors.forename: Susan E
authors.initials: SE
authors.lastname: Horton
authors.forename: Tran Q
authors.initials: TQ
authors.lastname: Phuc
authors.forename: Luong B
authors.initials: LB
authors.lastname: Phu
authors.forename: Dang T
authors.initials: DT
authors.lastname: Thach
authors.forename: Tran C
authors.initials: TC
authors.lastname: Dai
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fattore
authors.forename: Antonio
authors.initials: A
authors.lastname: Montresor
authors.forename: Beverley-A
authors.initials: BA
authors.lastname: Biggs
mesh_terms: D000740:Anemia / Q000150:complications* / Q000503:physiopathology / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D019587:Dietary Supplements / Q000191:economics*; D005260:Female; D005492:Folic Acid / Q000494:pharmacology*; D006725:Hookworm Infections / Q000628:therapy*; D006801:Humans; D007501:Iron / Q000494:pharmacology*; D011247:Pregnancy; D012098:Reproduction; D013997:Time Factors; D014744:Vietnam
chemical_list: D005492:Folic Acid; D007501:Iron