A Benefit-Cost Analysis of Nutritional Programs for Anemia Reduction

Abstract

O ne of the most common nutritional problems in both industrial and developing countries is iron deficiency anemia. In many developing countries, between one-and two-thirds of the population are affected. Anemia refers to a condition in which the concentration of hemoglobin (Hb) in the blood is below some norm for a given population. Although anemia may be due to factors such as disease or blood loss, its most common cause is a deficiency of iron (Charlton and Bothwell 1982). Such deficiency is typically caused by not consuming enough absorbable iron, relative to what the body needs for forming hemoglobin and other purposes. The Hb level provides the mechanism for carrying oxygen to muscles and other tissues of the body. At low hemoglobin levels, the body's ability to produce energy and meet other functional needs is limited. The anemic person feels weak and listless and may be more susceptible to infection. Work capacity is also impaired, and anemic children perform less well in school. Many of the consequences of anemia have been summarized (Pollitt and others 1982; Pollitt and Leibel 1976; Read 1975; Scrimshaw 1984). The purpose of this study is to review the available literature from the perspective of those concerned with investment in human resources. All investments have a cost-the value of the resources employed (Levin 1983)-and may also produce benefits. To reduce anemia, the costs stem from the iron supplements and the system for delivering them. The potential benefits are improved fetal and child growth, lower morbidity and mortality, higher productivity, more enjoyment of leisure, and more effective learning by students. Copyrightv) 1986 by the International Bank for Reconstruction and Dcvclopmcnt/The World Banik

Prevention of Iron Deficiency Anemia (IDA): How Far Have We Reached?

“…Levin [58] has prepared cost benefit analysis of IDA prevention through fortification and supplementation. The costs involved in fortification programmes include the fortificants, stabilizers, mixing, possibly special packaging and distribution.Overall, taking into account all these, the increase in cost for fortification is negligible.In India increase in cost of fortification of salt is 20%, in Guatemala to fortify sugar the rise is only 2%.…”

Potential impacts of iron biofortification in India

“…But how do the measures compare with non-agricultural micronutrient interventions? In an early study capturing different developing countries, Levin (1986) calculated BCRs in the range of 5-79 for industrial, commercial iron fortification and of 1.6-59 for pharmaceutical supplementation. In a more recent overview, Behrman et al (2004) gave BCRs of 176-200 for iron fortification and of 6.1-14 for supplementation.…”

A review of the MAFF Optimal Nutrition Status research programme: folate, iron and copper

“…Iron-deficiency anaemia (IDA) is anaemia caused by lack of iron in the body and iron-deficient erythropoiesis is an impairment in iron supply to the bone marrow in the absence of storage iron that may occur with haemoglobin levels still in the reference range 57 . The major consequences of iron lack include defects in psychomotor development in infants 58 -60 , impaired educational performance in schoolchildren 61 , increased perinatal morbidity 62 and impaired work capacity 63 . Few if any of the relevant investigations have demonstrated these abnormalities in the absence of anaemia 64 .…”