Scaling Up Nutrition in the Democratic Republic of Congo : What Will It Cost?

Shekar, Meera ; Mattern, Max ; Laviolette, Luc ; Dayton Eberwein, Julia ; Karamba, Wendy ; Akuoku, Jonathan Kweku

World Bank, Washington, DC

关键词: NUTRITION;    HEALTH FINANCE;    NUTRITION FINANCING;    COST EFFECTIVENESS;   

RP-ID  :  120109

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

This paper builds on global experienceand the DRC’s specific context to identify an effectivenutrition approach along with costs and benefits of keynutrition interventions. It is intended to help guide theselection of the most cost-effective interventions as wellas strategies for scaling these up. The paper considers bothrelevant ‘nutrition-specific’ interventions, largelydelivered through the health sector, and multisectoral‘nutrition-sensitive’ interventions, delivered through othersectors such as agriculture, education, and water andsanitation. The authors estimate that the costs and benefitsof implementing 10 nutrition-specific interventions in allprovinces of the DRC would require a yearly publicinvestment of $371 million. The expected benefits areenormous: annually over 5.4 million DALYs and over 76,000lives would be saved, while at least 1 million cases ofstunting among children under five would be averted.Economic productivity could potentially increase by $591million annually over the productive lives of thebeneficiaries, with an impressive internal rate of return of13.6 percent. However, because it is unlikely that theGovernment of the DRC or its partners will find the $371million necessary to reach full coverage, authors alsoconsider scale-up scenarios based on considerations of theirpotential for impact, burden of stunting, resourcerequirements, and implementation capacity. The mostcost-effective scenario considered would provide a subset ofkey interventions in provinces with the highest rates ofstunting and will cost between $97 and $185 milliondepending on how many provinces are covered. The authorsthen identify and cost six nutrition-sensitive interventionsrelevant to the DRC and for which there are both evidence ofpositive impact on nutrition outcomes and some costinformation. These findings point to a powerful set ofnutrition-specific interventions and a candidate list ofnutrition-sensitive approaches that represent a highlycost-effective approach to reducing child malnutrition inthe DRC.