(1) Background: This study aimed to quantify the health and economic impacts of air pollution in Jakarta Province, the capital of Indonesia. (2) Methods: We quantified the health and economic burden of fine particulate matter (PM2.5) and ground-level Ozone (O3), which exceeds the local and global ambient air quality standards. We selected health outcomes which include adverse health outcomes in children, all-cause mortality, and daily hospitalizations. We used comparative risk assessment methods to estimate health burdens attributable to PM2.5 and O3, linking the local population and selected health outcomes data with relative risks from the literature. The economic burdens were calculated using cost-of-illness and the value of the statistical life-year approach. (3) Results: Our results suggest over 7000 adverse health outcomes in children, over 10,000 deaths, and over 5000 hospitalizations that can be attributed to air pollution each year in Jakarta. The annual total cost of the health impact of air pollution reached approximately USD 2943.42 million. (4) Conclusions: By using local data to quantify and assess the health and economic impacts of air pollution in Jakarta, our study provides timely evidence needed to prioritize clean air actions to be taken to promote the public’s health.
Background In Indonesia, nearly half of all children aged less than six months were not exclusively breastfed in 2017. This study aimed to compare the cost of providing direct or indirect exclusive breastfeeding 0–6 months, partial exclusive breastfeeding and commercial milk formula only. This study also assessed the maternal socioeconomic and mental health factors to providing exclusive breastfeeding. Methods Data were collected in 2018 via a cross-sectional survey of 456 mothers in Bandung City and Purwakarta District, West Java Province, Indonesia, who had children aged less than six months. We used micro-costing to calculate the cost of productivity, equipment, supplies, and training of mothers when providing direct exclusive breastfeeding, indirect exclusive breastfeeding, partial exclusive breastfeeding (a mix of breastfeed and commercial milk formula), and infant formula/commercial milk formula only. Logistic regression was used to determine the impact of several independent variables, including mother’s level of depression, on exclusive breastfeeding. Results To provide direct exclusive breastfeeding, the cost per mother in the first six months is US$81.08, which is less expensive than indirect exclusive breastfeeding (US$171.15), partial exclusive breastfeeding (US$487.8) and commercial milk formula (US$494.9). We also found that education and age are associated with the decision to provide direct exclusive breastfeeding. Mothers who work will most likely provide indirect exclusive breastfeeding, commercial milk formula, or partial breastfeeding as opposed to direct exclusive breastfeeding. Finally, although severe depression symptoms have a positive relationship with the decision to provide commercial milk formula over direct exclusive breastfeeding, the evidence here is not strong. Conclusions The total cost of providing only commercial milk formula is 6-times higher than the cost of direct exclusive breastfeeding. The presence of severe depression symptoms is positively related to mothers opting for other feeding methods aside of direct exclusive breastfeeding and indirect exclusive breastfeeding. This study shows that direct exclusive breastfeeding is economically preferable to other methods, supports policies to reduce the time cost of exclusive breastfeeding (e.g., paid maternity leave and maternal cash transfers), and addresses the importance of mother’s mental health to ensure successful breastfeeding.
Background: In Indonesia, nearly half of all children aged < 6 months were not exclusively breastfed in 2017. This study aimed to estimate the cost of providing exclusive breastfeeding compared to partial exclusive breastfeeding and use of formula milk. This study also assessed the maternal socio-economic and mental health factors to providing exclusive breastfeeding. Methods: Data were collected in 2018 via a cross-sectional survey of 456 mothers in Bandung City and Purwakarta District who had children aged < 6 months. We used micro-costing to calculate the cost of productivity, equipment, supplies, and training for mothers when providing exclusive breastfeeding, partial exclusive breastfeeding, and formula milk. Logistic regression was used to determine the impact of several independent variables, including the mother's level of depression, on exclusive breastfeeding. Results: To breastfeed exclusively, a family needs to spend $ 116,95, which is less expensive than partial breastfeeding ($ 487,18) and providing only formula milk ($ 531,97). We also found that age, time spent on breastfeeding, and marital status positively influence the decision to breastfeed. On the other hand, working status, the number of children, and the total cost of the child’s nutrients negatively impact the decision. Finally, severe maternal depression symptoms were significantly negatively associated with the decision to exclusively breastfeed. Conclusion: The total cost of providing only formula milk is 3-times higher than the cost of exclusively breastfeeding, even after including the cost of providing breastfeeding time. The total cost and presence of severe depression symptoms are related to the mother’s decision to not exclusively breastfeed. This study found that exclusive breastfeeding is economically preferable to other methods and supports policies to reduce the time cost of exclusive breastfeeding and address the importance of the mother's mental health to ensure successful breastfeeding.
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