Poster Topical Area: Global Nutrition
Location: Hall D
Poster Board Number: 595
To run an 18-month blanket supplementary feeding program for children 6-24 months old, cost of caregivers' time to participate could be substantial in addition to costs incurred from the program perspective. We evaluated opportunity cost of caregivers' time and its impact on relative cost-effectiveness of four supplementary foods in preventing stunting and wasting as part of a Tufts-led USAID Food Aid Quality Review study in Burkina Faso.
Caregivers traveled monthly to the nearest Food Distribution Point to collect one of four isocaloric foods: three Fortified Blended Foods (FBFs) and a Ready-to-Use Supplementary Food (RUSF). Daily preparation and feeding also required their time. Surveys and in-home observations assessed time use. Hourly opportunity cost of caregivers' time was derived from national mandated minimum wage for domestic workers at USD0.21/hour. Caregiver opportunity cost per child reached was calculated for each arm, and summarized into cost from the societal (program plus caregiver) perspective. Its impact on overall relative cost-effectiveness of the four arms was assessed. Sensitivity analyses of caregiver's time amounts and values were conducted.
Food preparation led to the major difference in opportunity cost between the three FBFs and RUSF. Unlike the FBFs, RUSF requires no preparation. FBF porridge making was often combined with other activities. Based on observational data, 65.5% of preparation time was attributable to the study flours, equivalent to 22min per meal. Caregivers' opportunity cost per child over 18 months ranged from USD152 to USD179 for the three FBFs, and was USD99 for RUSF. This addition of caregiver time cost shifted RUSF from most expensive arm to second most expensive, and therefore affected some comparative rankings of the overall cost-effectiveness. Sensitivity analyses showed that changing values of the hourly wage or time attribution to study food preparation could alter relative cost effectiveness ranking of RUSF to different extents. In the most extreme cases, RUSF became comparable to the most cost-effective arm.
Caregivers' time was a substantial part of total societal cost, with differences among study foods due mainly to food preparation time. Time valuation could affect some relative rankings of cost-effectiveness.
Data Analyst/ Cost Specialist
Friedman School of Nutrition Science and Policy, Tufts University