Article type
Abstract
"Background: Vitamins and minerals (i.e. micronutrients; such as iron, folic acid, vitamin A, iodine, etc.) are essential for optimal health. Micronutrient deficiencies affect millions of people worldwide, leading to increased illness and death. Food fortification, the addition of micronutrients to foods while they are being processed, reduces micronutrient malnutrition and its negative sequelae. To our knowledge, the cost-effectiveness of food fortification has never been comprehensively and systematically reviewed. A better understanding of the economic implications of this population-level intervention could translate to improved global advocacy and implementation efforts. This evidence on food fortification may assist in implementation of Sustainable Development Goals’ target 2.2 addressing “all forms of malnutrition”.
Objectives: To synthesize evidence on cost-effectiveness and cost-savings associated with large-scale food fortification.
Methods: Protocol was registered a priori (PROSPERO CRD42023493795), following rigorous systematic review methodology. Searches were conducted up to January 2024 in six databases. Economic analyses that compared post-harvest micronutrient fortification of foods (including beverages and condiments) to either no fortification/unfortified foods/pre-fortification were eligible. Study eligibility was reviewed by two authors independently. Data extraction was conducted by one reviewer and crosschecked by a second. Quality appraisal checklists were selected: Philips’ Modelling Framework (modelling studies), and CAPHRI Consensus Health Economic Criteria (CHEC) List (primary studies). Detailed and summary-level data are presented in tables. Full analyses will soon be completed.
Results: Out of >6000 abstracts screened, >1500 full-texts were assessed, and over 40 studies were included. Cost-effectiveness estimates, along with cost savings, of food fortification were obtained from studies for more than 50 countries, predominantly representing low- and middle-income economies and spanning across world regions. Numerous micronutrient interventions were evaluated (versus eligible comparators) for diverse food vehicles (e.g. flour, oil, sugar, salt, milk, rice, etc.). All costing data are being converted to 2023 US$ for results comparability.
Conclusions: This systematic review is the largest on this topic. Evaluating cost-effectiveness and cost-savings of national food fortification programs is inherently specific to local contexts as malnutrition burdens, health systems, government subsidies, industry costs, diets, etc. vary significantly. This presentation will provide a high-level summary of specific methodology and key results on these important programs."
Objectives: To synthesize evidence on cost-effectiveness and cost-savings associated with large-scale food fortification.
Methods: Protocol was registered a priori (PROSPERO CRD42023493795), following rigorous systematic review methodology. Searches were conducted up to January 2024 in six databases. Economic analyses that compared post-harvest micronutrient fortification of foods (including beverages and condiments) to either no fortification/unfortified foods/pre-fortification were eligible. Study eligibility was reviewed by two authors independently. Data extraction was conducted by one reviewer and crosschecked by a second. Quality appraisal checklists were selected: Philips’ Modelling Framework (modelling studies), and CAPHRI Consensus Health Economic Criteria (CHEC) List (primary studies). Detailed and summary-level data are presented in tables. Full analyses will soon be completed.
Results: Out of >6000 abstracts screened, >1500 full-texts were assessed, and over 40 studies were included. Cost-effectiveness estimates, along with cost savings, of food fortification were obtained from studies for more than 50 countries, predominantly representing low- and middle-income economies and spanning across world regions. Numerous micronutrient interventions were evaluated (versus eligible comparators) for diverse food vehicles (e.g. flour, oil, sugar, salt, milk, rice, etc.). All costing data are being converted to 2023 US$ for results comparability.
Conclusions: This systematic review is the largest on this topic. Evaluating cost-effectiveness and cost-savings of national food fortification programs is inherently specific to local contexts as malnutrition burdens, health systems, government subsidies, industry costs, diets, etc. vary significantly. This presentation will provide a high-level summary of specific methodology and key results on these important programs."