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Ghana Priorities: Nutrition

Ghana is considered one of the few success stories on the African continent regarding child nutrition.

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Ghana Priorities: Nutrition

  1. 1. Target population • 174,000 more women (20% of mothers) Costs = 26m cedis • Direct cost of breastfeeding promotion is 60 cedis per woman • Assumed to require 6 consultations of 30 min each • Breastfeeding promotion would lead to roughly 27,000 women spending an extra 1 hour per day on breastfeeding and associated inconvenience • Limited evidence for this cost • However, many studies in Ghana and around the world show that breastfeeding is impacted by constraints such as work or household responsibilities Breastfeeding promotion would cost GHS 26m if it could reach 174,000 more women 13.7 1.4 10.4 - 5.0 10.0 15.0 20.0 25.0 30.0 GHS millions Cost of breastfeeding promotion annually (174,000 mothers) Government cost to promote breastfeeding Cost of mother's time to receive counselling Cost of mother's time breastfeeding Cost to govt Cost to mothers
  2. 2. BCR = 24 Benefits = 623m cedis • 50% increase in likelihood of EBF -> 43,000 extra women exclusively breastfeeding • 24% increase in likelihood of continued breastfeeding -> 20,600 continuing to breastfeed up to 2 years • 745 lives saved per year from reduced infection (60%-70% risk reduction) • 135,000 cases of respiratory infection avoided • 43,000 cases of diarrhea avoided • Benefits drawn from correlative studies between breastfeeding and child illness or mortality around the world Intervention would lead to 43,000 extra women exclusively breastfeeding and 745 lives saved 51% 76% 18% 9% 30% 15% 1% 0 0.2 0.4 0.6 0.8 1 1.2 Without intervention With intervention Expected changes in breastfeeding from intervention Exclusive Predominant Partial None - 100 200 300 400 500 600 700 GHS millions per year Annual benefits from breastfeeding Cases of illness avoided Lives saved
  3. 3. Target population • 174,000 more women (20% of mothers) Costs = 5m cedis • Direct cost of complementary feeding promotion is 28 cedis per woman • CHW provide 1-to-1 counseling at home • CHW are inexpensive – assumed to cost GHS 9 per hour or GHS 1,600 per month • Comparable to costs in other countries • Assumed to require 6-7 consultations of 15 min each Complementary feeding promotion is cheap – costing GHS 28 per mother or GHS 5m 4.6 0.3 - 1.0 2.0 3.0 4.0 5.0 6.0 GHS millions Cost of complementary feeding promotion for 174,000 women Maternal time Govt cost of complementary feeding promotion
  4. 4. BCR = 36 Benefits = 178m cedis • 16% reduction in stunting -> 4,350 children avoiding stunting • 30% increase in lifetime wages from avoided stunting = 30,000 cedis in today’s value • Based on studies linking stunting to height reduction and height to wages across developing world • Lower than estimate from Guatemala in 1970s (66%) • 65 child deaths avoided due to better nutrition CF promotion would reduce (moderate and severe) stunting by 16% (3pp) + avoid 65 deaths 52% 47% 17% 14% 3% 0% 10% 20% 30% 40% 50% 60% 70% 80% Without intervention With intervention Percent of child Stunting Changes in stunting prevalence from intervention Mild Moderate Severe 0 20 40 60 80 100 120 140 160 180 200 Benefits from intervention (millions cedi) Millions of GHS Benefit from interventions Short run health benefit Long run productivity benefit
  5. 5. Target population • 174,000 HH with young children (20% of mothers) Costs = 1,400m cedis • Costs 8,025 cedis per HH • Very resource intensive – requires transfer of 40 chickens per HH • Large amounts of intense training (50%+ of cost) Benefits = GHS 2,174m • Income boost of 4,000 cedis per year • 29% reduction in stunting • 120 child deaths avoided Nutrition sensitive agriculture has a BCR of 1.6 1,394 - 1,823 261 89 - 500 1,000 1,500 2,000 2,500 Costs Benefits GHS millions Costs and benefits of nutrition sensitive agriculture program for 174k HHs Income earned Productivity benefits Health benefits BCR 1.6
  6. 6. SUMMARY BCR TABLE INTERVENTION BENEFITS (GHS MILLION) COSTS (GHS MILLION) BCR Multiple micronutrients and Calcium in pregnancy 3,585 203 18 Breastfeeding promotion 623 26 24 Complementary feeding promotion 178 4.9 36 Nutrition sensitive agriculture 2,174 1,394 1.6

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