Adherence
Nutrition-sensitive programs that utilize direct food transfers or asset transfers (such as livestock or poultry) yield the largest improvements in micronutrient intake (iron, zinc, vitamin A, animal protein) for children under five, but incur significantly higher costs per child reached compared to programs focused on education, media campaigns, or market access.
For maximum nutritional impact in resource-poor settings, direct provision of food or productive assets (like livestock or seeds) to families with young children is more effective at closing critical nutrient gaps (iron, zinc, vitamin A) than education or cash alone. However, this comes at a significantly higher financial cost. Decision-makers must weigh the higher immediate expense against the greater health benefits for children, recognizing that cheaper education-only programs may not sufficiently improve dietary quality.
When evaluated by mechanisms of impact, programs involving direct changes in intake via food transfers were generally estimated to produce larger changes in intakes of target nutrients than programs utilizing other mechanisms of impact... The most expensive programs per child used transfers of valuable assets such as livestock, garden supplies and cash, while the least costly programs used outreach and food pricing or market access...
Why this rating
The study uses a robust mixed-methods approach with expert consensus, literature validation, and specific country data, though it is an estimation/modeling study rather than a randomized controlled trial of the specific programs.
Source
Designing programs to improve diets for maternal and child health: estimating costs and potential dietary impacts of nutrition-sensitive programs in Ethiopia, Nigeria, and India
William A. Masters et al. · Health Policy and Planning · 2018
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