Abstract

Objectives

This article presents a benefit-cost analysis of scaling-up a subset of nutrition interventions administered in the Republic of Yemen with moderate to strong evidence of impact over 2024 to 2030. It also undertakes a cost-effectiveness analysis of adding interventions that are a part of the currently implemented nutrition package but with a weak evidence base.

Methods

We value economic benefits by converting the change in outcome expected from each intervention into a monetary value, in terms of savings from illness costs and future earnings from productivity and cognitive gains, discounted to its present value. To compare cost-effectiveness across packages, we calculate gain in disability-adjusted life-years as equivalent to the incremental improvement in outcomes from the additional coverage.

Results

The benefit-cost ratio for the scale-up is 2.23. The ratio remains above 1 with stricter assumptions. The incremental cost-effectiveness ratio of scaling up with the 2 additional investments is US$1337/disability-adjusted life-year for the 7-year period and is the equivalent of 0.6 times the current gross domestic product per capita, within a recommended cost-effectiveness threshold.

Conclusions

Because the additional cost of scaling up a comprehensive package is 40% of what the scale-up of the core package would cost for the period, it will need careful consideration of whether the scale-up for additional interventions with weak evidence in support of their effectiveness is warranted, even if the incremental cost-effectiveness ratio meets the threshold requirement.