Wasted Children and Wasted Time: A Challenge to Meeting the Nutrition Sustainable Development Goals with a High Economic Impact to Ethiopia
Abstract
:1. Introduction
2. Materials and Methods
2.1. Annual Average Rate of Reduction Calculation
2.2. Consequence Model: Economic Burden of Wasting in 2019
2.2.1. Pathway 1: Child Mortality Attributable to Malnutrition, and Estimated Value of Workforce Lost to Child Mortality
- Population attributable risk: The population attributable risk (PAR) is a function of the prevalence of the nutrition indicator along with the severity of the mortality risk, as expressed by the relative risk (RR: see Table 1). It is calculated with the following formula: (Prevalence × (RR − 1))/(1 + (Prevalence × (RR − 1))).
- Mortality in risk group affected: number of deaths per year based on national data
- Labor force participation: All: 91.2%, Male: 88.4%, and Female: 73.4% [20]
- Average earnings: 790/year USD, based on World Bank estimates
- Net present value: Net present value (NPV) is a subjective factor used to define the value of future goods or services and expresses that value in current currency. To calculate this NPV of lost future earnings due to the various indicators of malnutrition, we used a 3% discount rate, recommended by the World Bank for social investments [21]. As a sensitivity parameter, a 7% discount rate was also used, as recommended by other organizations [22].
2.2.2. Pathway 2: Child Cognition Deficit Resulting in Inferior School Performance and Adult Productivity
2.2.3. Pathway 3: Current Value of Reduced Productivity in Working Adults
2.2.4. Pathway 4: Current Value of Preventable Treatment Cost
- 10% of the SAM children will go through a stabilization center (UNICEF Ethiopia estimates)
- Cost, including supply, training, and monitoring: 40.27 USD/child for moderately wasted children (MAM), 80 USD/child for a severely wasted child (SAM) in out-patient treatment (OPT), 120 USD/child for a SAM in a stabilization center (SC) and then OPT
- Cost of labor: to estimate the cost of the health extension worker (HEW) during the following visits, we have estimated that he works 196 h/month and receives a salary of 150 USD/month. Therefore, his cost per hour of work is equal to 0.76 USD. A similar calculation was done for a health worker (HW) who works 196 h/month and receives a salary of 198 USD/month. His cost per hour will be equal to 1.01 USD. If we consider that each contact with a wasted child is 20 min, a MAM child with eight visits will cost 1.8 USD, a SAM child (OTP) with 12 visits will each cost 2.7 USD, while a SAM child (SC+OTP) with 19 visits will costs 4.9 USD.
2.3. Calculation of Averted SAM Cases and Potential Economic Saving Model over theYear
2.3.1. Averted SAM Cases
2.3.2. Potential Economic Saving Model over the Year
3. Results
4. Discussion
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Diseases Topic | RR |
---|---|
Pneumonia among children with anthropometric indicator zscore < −3SD | 9.7 |
Pneumonia among children with anthropometric indicator −3SD < zscore < −2SD | 4.7 |
Pneumonia among children with anthropometric indicator −2SD < zscore < −1SD | 1.9 |
Diarrhea among children with anthropometric indicator zscore < −3SD | 12.3 |
Diarrhea among children with anthropometric indicator −3SD < zscore < −2SD | 3.4 |
Diarrhea among children with anthropometric indicator −2SD < zscore < −1SD | 1.6 |
Measles among children with anthropometric indicator zscore < −3SD | 9.6 |
Measles among children with anthropometric indicator −3SD < zscore < −2SD | 2.6 |
Measles among children with anthropometric indicator −2SD < zscore < −1SD | 1 |
Other among children with anthropometric indicator zscore < −3SD | 11.2 |
Other among children with anthropometric indicator −3SD < zscore < −2SD | 2.7 |
Other among children with anthropometric indicator −2SD < zscore <−1SD | 1.7 |
Wasting Target (Prevalence in % by 2030) | Estimated AARR Required * | Number of Moderately Wasted Children (MAM) Adverted Cases | Number of Severe Acute Malnutrition (SAM) Averted Cases |
---|---|---|---|
≤5% (SDG target) | 5.4% | 5.5 million | 2.4 million |
5–6% | 3.7% | 4.0 million | 1.7 million |
7% | 2.2% | 2.5 million | 1.1 million |
8% | 0.9% | 1 million | 0.43 million |
Annual Average Rate of Reduction (AARR) | Pathway 1: Lost Workforce due to Child Mortality * | Pathway 2: Child Cognition and Adult Productivity * | Pathway 3: Current Productivity ** | Pathway 4: Health Cost ** | Total Capital Saved in Million USD | |
---|---|---|---|---|---|---|
3% discount rate | 5.40% | 88.7 | 79.2 | 82.2 | 439.8 | 689.9 |
3.70% | 66.4 | 79.2 | 59.7 | 319.6 | 524.9 | |
2.20% | 45.4 | 79.2 | 37.3 | 199.7 | 361.6 | |
0.90% | 25.4 | 79.2 | 14.9 | 79.7 | 199.2 | |
7% discount rate | 5.40% | 55.2 | 17.02 | 82.2 | 439.8 | 594.22 |
3.70% | 47 | 17.02 | 59.7 | 319.6 | 443.32 | |
2.20% | 40.2 | 17.02 | 37.3 | 199.7 | 294.22 | |
0.90% | 33.5 | 17.02 | 14.9 | 79.7 | 145.12 |
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Laillou, A.; Baye, K.; Meseret, Z.; Darsene, H.; Rashid, A.; Chitekwe, S. Wasted Children and Wasted Time: A Challenge to Meeting the Nutrition Sustainable Development Goals with a High Economic Impact to Ethiopia. Nutrients 2020, 12, 3698. https://doi.org/10.3390/nu12123698
Laillou A, Baye K, Meseret Z, Darsene H, Rashid A, Chitekwe S. Wasted Children and Wasted Time: A Challenge to Meeting the Nutrition Sustainable Development Goals with a High Economic Impact to Ethiopia. Nutrients. 2020; 12(12):3698. https://doi.org/10.3390/nu12123698
Chicago/Turabian StyleLaillou, Arnaud, Kaleab Baye, Zelalem Meseret, Hiwot Darsene, Abdulai Rashid, and Stanley Chitekwe. 2020. "Wasted Children and Wasted Time: A Challenge to Meeting the Nutrition Sustainable Development Goals with a High Economic Impact to Ethiopia" Nutrients 12, no. 12: 3698. https://doi.org/10.3390/nu12123698