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Stunting: an overlooked problem in Myanmar – an economic evaluation

Published online by Cambridge University Press:  20 January 2020

San Kyu Kyu Aye Open the ORCID record for San Kyu Kyu Aye [Opens in a new window] ,
Swe Le Mar ,
Nyi Nyi Lwin ,
Zar Lwin Hnin ,
Lwin Mar Hlaing ,
Michael L. Washington  and
Julie R. Harris
San Kyu Kyu Aye*
Affiliation:
Department of Preventive and Social Medicine, University of Medicine Mandalay, Mandalay, Myanmar
Swe Le Mar
Affiliation:
Department of Public Health, National Nutrition Centre, Naypyitaw, Myanmar
Nyi Nyi Lwin
Affiliation:
Department of Public Health, Sagaing Regional Public Health Department, Monywa, Myanmar
Zar Lwin Hnin
Affiliation:
Department of Preventive and Social Medicine, University of Medicine Mandalay, Mandalay, Myanmar
Lwin Mar Hlaing
Affiliation:
Department of Public Health, National Nutrition Centre, Naypyitaw, Myanmar
Michael L. Washington
Affiliation:
US Centers for Disease Control and Prevention, Health Economics and Modeling Unit, Atlanta, GA, USA
Julie R. Harris
Affiliation:
US Centers for Disease Control and Prevention, Workforce and Institute Development Branch, Atlanta, GA, USA
*
Author for Correspondence: San Kyu Kyu Aye, E-mail: sankyukyuaye@gmail.com
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Abstract

Objectives

Stunting increases a child's susceptibility to diseases, increases mortality, and is associated over long term with reduced cognitive abilities, educational achievement, and productivity. We aimed to assess the most effective public health nutritional intervention to reduce stunting in Myanmar.

Methods

We searched the literature and developed a conceptual framework for interventions known to reduce stunting. We focused on the highest impact and most feasible interventions to reduce stunting in Myanmar, described policies to implement them, and compared their costs and projected effect on stunting using data-based decision trees. We estimated costs from the government perspective and calculated total projected cases of stunting prevented and cost per case prevented (cost-effectiveness). All interventions were compared to projected cases of stunting resulting from the current situation (e.g., no additional interventions).

Results

Three new policy options were identified. Operational feasibility for all three options ranged from medium to high. Compared to the current situation, two were similarly cost-effective, at an additional USD 598 and USD 667 per case of stunting averted. The third option was much less cost-effective, at an additional USD 27,741 per case averted. However, if donor agencies were to expand their support in option three to the entire country, the prevalence of 22.5 percent would be reached by 2025 at an additional USD 667 per case averted.

Conclusions

A policy option involving immediate expansion of the current implementation of proven nutrition-specific interventions is feasible. It would have the highest impact on stunting and would approach the WHO 2025 target.

Keywords

StuntingNutritionHealth policyMyanmarEconomic Evaluation
Type
Policy
Information
International Journal of Technology Assessment in Health Care , Volume 36 , Issue 2 , April 2020 , pp. 167 - 172
Copyright
Copyright © Cambridge University Press 2020

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