University College London, Institute for Global Health, 30 Guilford Street, London, WC1N 1EH, UK.
London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT,, UK.
Trials. 2019 May 27;20(1):287. doi: 10.1186/s13063-019-3388-2.
Undernutrition causes around 3.1 million child deaths annually, around 45% of all child deaths. India has one of the highest proportions of maternal and child undernutrition globally. To accelerate reductions in undernutrition, nutrition-specific interventions need to be coupled with nutrition-sensitive programmes that tackle the underlying causes of undernutrition. This paper describes the planned economic evaluation of the UPAVAN trial, a four-arm, cluster randomised controlled trial that tests the nutritional and agricultural impacts of an innovative agriculture extension platform of women's groups viewing videos on nutrition-sensitive agriculture practices, coupled with a nutrition-specific behaviour-change intervention of videos on nutrition, and a participatory learning and action approach.
The economic evaluation of the UPAVAN interventions will be conducted from a societal perspective, taking into account all costs incurred by the implementing agency (programme costs), community and health care providers, and participants and their households, and all measurable outcomes associated with the interventions. All direct and indirect costs, including time costs and donated goods, will be estimated. The economic evaluation will take the form of a cost-consequence analysis, comparing incremental costs and incremental changes in the outcomes of the interventions, compared with the status quo. Robustness of the results will be assessed through a series of sensitivity analyses. In addition, an analysis of the equity impact of the interventions will be conducted.
Evidence on the cost and cost-effectiveness of nutrition-sensitive agriculture interventions is scarce. This limits understanding of the costs of rolling out or scaling up programs. The findings of this economic evaluation will provide useful information for different multisectoral stakeholders involved in the planning and implementation of nutrition-sensitive agriculture programmes.
ISRCTN65922679 . Registered on 21 December 2016.
营养不良每年导致约 310 万儿童死亡，约占所有儿童死亡人数的 45%。印度是全球孕产妇和儿童营养不良比例最高的国家之一。为了加速减少营养不良，营养具体干预措施需要与解决营养不良根本原因的营养敏感方案相结合。本文介绍了 UPAVAN 试验的计划经济评估，该试验是一项四臂、集群随机对照试验，测试了妇女团体观看营养敏感农业实践视频的创新农业推广平台的营养和农业影响，同时还结合了营养具体行为改变干预措施，即营养视频，以及参与式学习和行动方法。
将从社会角度对 UPAVAN 干预措施进行经济评估，考虑实施机构（方案成本）、社区和医疗保健提供者以及参与者及其家庭所产生的所有成本，以及与干预措施相关的所有可衡量的结果。将估计所有直接和间接成本，包括时间成本和捐赠物品。经济评估将采用成本效益分析的形式，比较干预措施的增量成本和结果的变化，与现状进行比较。将通过一系列敏感性分析评估结果的稳健性。此外，还将对干预措施的公平影响进行分析。
营养敏感农业干预措施的成本和成本效益证据稀缺。这限制了对推出或扩大方案的成本的理解。这项经济评估的结果将为参与营养敏感农业计划规划和实施的不同多部门利益相关者提供有用的信息。
ISRCTN65922679。于 2016 年 12 月 21 日注册。
