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To examine the association between remittances and food security in Bangladesh, controlling for other key factors.
Design:
The secondary data analysis was performed on the most recent (2016) nationally representative Household Income and Expenditure Survey. We used logistic regression models to measure the association between food security of the household and remittances received. The household food security was measured based on expenditure on food items and the energy intake of the household members. The key explanatory variables included the receipt of remittances by the household and household-level socio-economic characteristics.
Setting:
Bangladesh.
Participants:
Totally, 45 977 households across seven divisions of Bangladesh.
Results:
Findings suggested that remittances have a significant positive effect on food security. Further, the households with female heads were significantly more likely to be food insecure. The wealth status and geographical locations were significantly associated with food security status in Bangladesh.
Conclusions:
The findings highlight the importance of considering remittance as one of the key factors, while stakeholders implement nutritional interventions in Bangladesh and other low-income settings. Future research should consider this as an important determinant while further examining food security in such settings.
We estimated the cost-effectiveness of home fortification with micronutrient powder delivered in a sales-based programme in reducing the prevalence of Fe deficiency anaemia among children 6–59 months in Bangladesh.
Design:
Cross-sectional interviews with local and central-level programme staff and document reviews were conducted. Using an activity-based costing approach, we estimated start-up and implementation costs of the programme. The incremental cost per anaemia case averted and disability-adjusted life years (DALY) averted were estimated by comparing the home fortification programme and no intervention scenarios.
Setting:
The home fortification programme was implemented in 164 upazilas (sub-districts) in Bangladesh.
Participants:
Caregivers of child 6–59 months and BRAC staff members including community health workers were the participants for this study.
Results:
The home fortification programme had an estimated total start-up cost of 35·46 million BDT (456 thousand USD) and implementation cost of 1111·63 million BDT (14·12 million USD). The incremental cost per Fe deficiency anaemia case averted and per DALY averted was estimated to be 1749 BDT (22·2 USD) and 12 558 BDT (159·3 USD), respectively. Considering per capita gross domestic product (1516·5 USD) as the cost-effectiveness threshold, the home fortification programme was highly cost-effective. The programme coverage and costs for nutritional counselling of the beneficiary were influential parameters for cost per DALY averted in the one-way sensitivity analysis.
Conclusions:
The market-based home fortification programme was a highly cost-effective mechanism for delivering micronutrients to a large number of children in Bangladesh. The policymakers should consider funding and sustaining large-scale sales-based micronutrient home fortification efforts assuming the clear population-level need and potential to benefit persists.
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