Ending malnutrition in all its forms requires scaling up proven nutrition interventions and much more: a 129-country ana
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RESEARCH ARTICLE
Open Access
Ending malnutrition in all its forms requires scaling up proven nutrition interventions and much more: a 129-country analysis Nick Scott1,2*, Dominic Delport1, Samuel Hainsworth1, Ruth Pearson1, Christopher Morgan1,3,4, Shan Huang1, Jonathan K. Akuoku5, Ellen Piwoz6, Meera Shekar5, Carol Levin7, Mike Toole1 and Caroline SE Homer1
Abstract Background: Sustainable Development Goal (SDG) 2.2 calls for an end to all forms of malnutrition, with 2025 targets of a 40% reduction in stunting (relative to 2012), for wasting to occur in less than 5% of children, and for a 50% reduction in anaemia in women (15–49 years). We assessed the likelihood of countries reaching these targets by scaling up proven interventions and identified priority interventions, based on cost-effectiveness. Methods: For 129 countries, the Optima Nutrition model was used to compare 2019–2030 nutrition outcomes between a status quo (maintained intervention coverage) scenario and a scenario where outcome-specific interventions were scaled up to 95% coverage over 5 years. The average cost-effectiveness of each intervention was calculated as it was added to an expanding package of interventions. Results: Of the 129 countries modelled, 46 (36%), 66 (51%) and 0 (0%) were on track to achieve the stunting, wasting and anaemia targets respectively. Scaling up 18 nutrition interventions increased the number of countries reaching the SDG 2.2 targets to 50 (39%), 83 (64%) and 7 (5%) respectively. Intermittent preventative treatment of malaria during pregnancy (IPTp), infant and young child feeding education, vitamin A supplementation and lipidbased nutrition supplements for children produced 88% of the total impact on stunting, with average costs per case averted of US$103, US$267, US$556 and US$1795 when interventions were consecutively scaled up, respectively. Vitamin A supplementation and cash transfers produced 100% of the total global impact on prevention of wasting, with average costs per case averted of US$1989 and US$19,427, respectively. IPTp, iron and folic acid supplementation for non-pregnant women, and multiple micronutrient supplementation for pregnant women produced 85% of the total impact on anaemia prevalence, with average costs per case averted of US$9, US$35 and US$47, respectively. Conclusions: Prioritising nutrition investment to the most cost-effective interventions within the country context can maximise the impact of funding. A greater focus on complementing nutrition-specific interventions with nutritionsensitive ones that address the social determinants of health is critical to reach the SDG targets. Keywords: Economic analysis, Mathematical model, Nutrition, Optima Nutrition, Sustainable Development Goals
* Correspondence: [email protected] 1 Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia 2 School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia Full list of author information is available at the end of the article © The Aut
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