title: Cost analysis of community-based daily and weekly programs for treatment of moderate and mild wasting among children on Nias Island, Indonesia.
abstract: BACKGROUND
  Ready-to-use food in the form of biscuits (RUF-Nias biscuit) was locally produced for rehabilitation of moderately and mildly wasted (weight-for-height z-score > or = -3 to < -1.5 SD) children on Nias Island, Indonesia. Daily programs were performed in semiurban settings, and weekly programs took place in rural areas.
  
  
  OBJECTIVE
  To analyze the cost of daily and weekly distribution and supervision of RUF-Nias biscuit programs.
  
  
  METHODS
  The costs of the daily and weekly programs were derived from the financial report and interviews with program implementers and participating households. Costs were calculated on the basis of total rehabilitation costs per child per day required to achieve a target weight-for-height z-score > or = -1.5 SD in daily and weekly programs.
  
  
  RESULTS
  Institutional costs to the implementing organization were similar for both programs (approximately US $4 per child per day). The daily programs resulted in a significantly higher proportion of recovered children (78.6% vs. 65.4%) and higher weight gain (3.7 vs. 2.2 g/kg/day) than the weekly programs. About 6% to 7% of the total cost of the programs was accounted for by locally produced RUF-Nias biscuits. The social cost borne by the community for the weekly programs was about half that for the daily programs.
  
  
  CONCLUSIONS
  The daily programs achieved better results for the implementing organization than the weekly programs; however, the weekly programs were preferred by the community because of the lower time constraints and the lower opportunity cost of time. The willingness of community and household members to invest their time in more intensive activities in the daily programs led to better program outcomes.
authors.affiliation: Institute for Social Sciences in Agriculture, Center of Gender and Nutrition, University of Hohenheim, Stuttgart, Germany.
authors.forename: Ratna Chrismiari
authors.initials: RC
authors.lastname: Purwestri
authors.forename: Veronika
authors.initials: V
authors.lastname: Scherbaum
authors.forename: Dyah Ayu
authors.initials: DA
authors.lastname: Inayati
authors.forename: Nia Novita
authors.initials: NN
authors.lastname: Wirawan
authors.forename: Julia
authors.initials: J
authors.lastname: Suryantan
authors.forename: Maurice Alexander
authors.initials: MA
authors.lastname: Bloem
authors.forename: Rosnani Verba
authors.initials: RV
authors.lastname: Pangaribuan
authors.forename: Volker
authors.initials: V
authors.lastname: Hoffmann
authors.forename: Hans Konrad
authors.initials: HK
authors.lastname: Biesalski
authors.forename: Matin
authors.initials: M
authors.lastname: Qaim
authors.forename: Anne Camilla
authors.initials: AC
authors.lastname: Bellows
mesh_terms: D002675:Child, Preschool; D003365:Costs and Cost Analysis; D003695:Delivery of Health Care / Q000191:economics*; D019587:Dietary Supplements; D057140:Fast Foods; D005260:Female; D006801:Humans; D007214:Indonesia; D007223:Infant; D008297:Male; D044342:Malnutrition / Q000178:diet therapy; D012424:Rural Population; D013997:Time Factors; D014505:Urban Population; D019282:Wasting Syndrome / Q000178:diet therapy* / Q000534:rehabilitation; D015430:Weight Gain