Bagriansky Jack, Champa Ngy, Pak Kimchoeun, Whitney Sophie, Laillou Arnaud
United Nations Children's Fund (UNICEF), No.11, Street 75, Sangkat Sraschark, Phnom Penh, Cambodia.
Asia Pac J Clin Nutr. 2014;23(4):524-31. doi: 10.6133/apjcn.2014.23.4.08.
Cambodia is among the 28 worst countries globally with the highest rates of childhood malnutrition. The aim of the assessment was to apply published evidence associating malnutrition and a variety of functional consequences to project economic implications of this high rate of childhood malnutrition. Such information is vital to advocate for appropriate programs and action plan to reduce malnutrition (from severe stunting to micronutrient deficiencies).
This exercise used a "consequence model" to apply these "coefficients of loss" established in the global scientific literature to Cambodia health, demographic and economic data to develop a national estimation of the economic losses link to malnutrition.
The impact of the indicators of malnutrition analysed represent a burden to the national economy of Cambodia estimated at more than $400 million annually -2.5% of GDP. Micronutrient deficiencies suggest deficits in the quality of the diet - representing a national burden of more than $200 million annually while breastfeeding behaviours account for 6% of the burden. 57% of the losses emerge from indicators measured in children, while 43% of losses are from indicators independent of childhood measurements - indicators of maternal behaviour along with maternal and adult nutrition.
Given the low cost of interventions and the high baseline losses, investment in nutrition programs in Cambodia is likely to offer high returns and attractive benefit cost ratios. Since nearly half the losses are determined prior to the birth of the child, this has implications for targeting and timing of programs.
柬埔寨是全球儿童营养不良率最高的28个最糟糕国家之一。评估的目的是运用已发表的将营养不良与各种功能后果相关联的证据,来推算这种高儿童营养不良率的项目经济影响。此类信息对于倡导制定适当的计划和行动计划以减少营养不良(从严重发育迟缓到微量营养素缺乏)至关重要。
本研究运用了一个“后果模型”,将全球科学文献中确定的这些“损失系数”应用于柬埔寨的健康、人口和经济数据,以对与营养不良相关的经济损失进行全国性估算。
所分析的营养不良指标的影响对柬埔寨国民经济造成了负担,估计每年超过4亿美元,占国内生产总值的2.5%。微量营养素缺乏表明饮食质量存在缺陷,每年造成的国家负担超过2亿美元,而母乳喂养行为占负担的6%。57%的损失来自儿童测量指标,而43%的损失来自与儿童测量无关的指标——母亲行为以及母亲和成人营养指标。
鉴于干预成本低且基线损失高,在柬埔寨投资营养项目可能会带来高回报和有吸引力的效益成本比。由于近一半的损失在儿童出生前就已确定,这对项目的目标设定和时机选择具有影响。