Cost-effectiveness of 4 specialized nutritious foods in the prevention of stunting and wasting in children aged 6-23 months in Burkina Faso: A geographically randomized trial

Ilana R. Cliffer, Laetitia Nikiema, Breanne K. Langlois, Augustin N. Zeba, Ye Shen, Hermann B. Lanou, Devika J. Suri, Franck Garanet, Kenneth Chui, Stephen Vosti, Shelley Walton, Irwin Rosenberg, Patrick Webb, Beatrice L. Rogers

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Abstract

Background: There is a variety of specialized nutritious foods available for use in programs targeting undernutrition, but evidence supporting the choice of product is limited. Objectives: We compared the cost-effectiveness of 4 specialized nutritious foods to prevent stunting and wasting in children aged 6-23 mo in Burkina Faso. Methods: Four geographic regions were randomly assigned to 1 of 4 intervention arms: Corn-Soy Blend Plus (CSB+) programmed with separate fortified vegetable oil (the reference food), Corn-Soy-Whey Blend (CSWB; a new formulation) with oil, SuperCereal Plus (SC+), and ready-to-use supplementary food (RUSF). We compared the effects of each intervention arm on growth (length-for-age z score (LAZ), weight-for-length z score (WLZ), end-line stunting (LAZ < -2), and total monthly measurements of wasting (WLZ < -2). Rations were ~500 kcal/d, distributed monthly. Children were enrolled in the blanket supplementary feeding program at age ~6 mo and measured monthly for ~18 mo. Average costs per child reached were linked with effectiveness to compare the cost-effectiveness of each arm with CSB+ with oil. Results: In our sample of 6112 children (CSB+, n = 1519; CSWB, n = 1503; SC+, n = 1564; RUSF, n = 1526), none of the foods prevented declines in growth. Children in the SC+ and RUSF arms were not significantly different than those in the CSB+ with oil arm. Children in the CSWB with oil arm experienced higher end-line (measurement at age 22.9-23.9 mo) stunting (OR: 2.07; 95% CI: 1.46, 2.94) and more months of wasting (incidence rate ratio: 1.29; 95% CI: 1.09, 1.51). CSB+ with oil was the least-expensive ration in all costing scenarios ($113-131 2018 US dollars/enrolled child) and similar in effectiveness to SC+ and RUSF, and thus the most cost-effective product for the defined purposes. Conclusions: CSB+ with oil was the most cost-effective ration in the prevention of wasting and stunting in this trial.

Original languageEnglish (US)
Article numbernzaa006
JournalCurrent Developments in Nutrition
Volume4
Issue number2
DOIs
StatePublished - Feb 1 2020

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Keywords

  • Children
  • Complementary feeding
  • Corn-soy blend
  • Cost-effectiveness
  • Food aid
  • Lipid-based nutrient supplements
  • Low-income countries
  • Stunting
  • Supplementary feeding
  • Wasting

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science
  • Nutrition and Dietetics

Cite this

Cliffer, I. R., Nikiema, L., Langlois, B. K., Zeba, A. N., Shen, Y., Lanou, H. B., Suri, D. J., Garanet, F., Chui, K., Vosti, S., Walton, S., Rosenberg, I., Webb, P., & Rogers, B. L. (2020). Cost-effectiveness of 4 specialized nutritious foods in the prevention of stunting and wasting in children aged 6-23 months in Burkina Faso: A geographically randomized trial. Current Developments in Nutrition, 4(2), [nzaa006]. https://doi.org/10.1093/cdn/nzaa006