Cognitive development among children in a low-income setting: cost-effectiveness analysis of a maternal nutrition education intervention in rural Uganda

Inadequate nutrition and insufficient stimulation in early childhood can lead to long-term deficits in cognitive and social development. Evidence for policy and decision-making regarding the cost of delivering nutrition education is lacking in low and middle-income countries (LMIC). In rural Uganda, we conducted a cluster-randomized controlled trial (RCT) examining the effect of a maternal nutrition education intervention on developmental outcomes among children aged 6–8 months. This intervention led to significantly improved cognitive scores when the children reached the age of 20–24 months. When considering the potential for this intervention’s future implementation, the desired effects should be weighed against the increased costs. This study therefore aimed to assess the cost-effectiveness of this education intervention compared with current practice. Health outcome data were based on the RCT. Cost data were collected via interviews with researchers involved in processing the interv..., Data was obtained from a randomized controlled education trial performed among mothers of small children residing in rural Uganda.  The trial is described in Muhoozi et al Matern Child Nutr. 2018;14(2): e12527.
We then applied a cost-effectiveness analysis, including calculations of incremental cost-effectiveness ratios. In addition, uncertainty in the results was characterized using one-way and probabilistic sensitivity analyses. Stata/SE version 15.1 was used for statistical analyses. Microsoft Excel was used to perform the cost-effectiveness analyses.,

儿童早期营养摄入不足与刺激匮乏，可引发认知与社会发展的长期缺陷。针对中低收入国家（low and middle-income countries, LMIC）开展营养教育的实施成本制定政策与决策的相关证据仍较为匮乏。我们在乌干达农村地区开展了一项整群随机对照试验（cluster-randomized controlled trial, RCT），探究母亲营养教育干预对6~8月龄儿童发育结局的影响。该干预可使儿童在20~24月龄时的认知评分得到显著提升。在考量该干预未来推广的潜在价值时，需将其预期效益与新增成本进行权衡。因此，本研究旨在评估该营养教育干预相较于当前常规实践的成本效益。健康结局数据源自本次随机对照试验，成本数据则通过访谈参与数据处理的研究人员收集（原文此处存在截断）。本数据集源自一项针对乌干达农村地区幼儿母亲开展的随机对照教育试验，相关试验细节已由Muhoozi等学者发表于《Matern Child Nutr》2018年第14卷第2期，文章编号为e12527。随后我们开展了成本效益分析，包括增量成本效益比（incremental cost-effectiveness ratios, ICER）的计算。此外，我们通过单因素敏感性分析与概率敏感性分析对研究结果的不确定性进行了量化表征。统计分析采用Stata/SE 15.1版本完成，成本效益分析则借助Microsoft Excel完成。