Poster Topical Area: Global Nutrition

Location: Hall D

Poster Board Number: 595

P12-106 - Evaluating Opportunity Cost of Caregivers’ Time and its Impact on Comparative Cost-Effectiveness of Supplementary Foods to Prevent Child Undernutrition in Burkina Faso

Monday, Jun 11
8:00 AM – 3:00 PM

Objective
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.

Method
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.

Result
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.

Conclusion
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.




Funding Source: This research was performed under the extension of the Food Aid Quality Review (FAQR III) project implemented for the USAID Office of Food for Peace by Tufts University Friedman School of Nutrition Science and Policy. This poster is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of Tufts University under the terms of AID-OAA-C-16-00020 and do not necessarily reflect the views of USAID or the United States Government. The partner Title II program, Victoire sur la Malnutrition (ViM) operated in Burkina Faso under the management of ACDI/VOCA was implemented by Save the Children. Institut de Recherche en Sciences de la Sante (IRSS), a research institution within the Centre National de la Recherche Scientifique et Technologique (CNRST) in Burkina Faso served as a research partner and conducted data collection.

CoAuthors: Ilana Cliffer – Friedman School of Nutrition Science and Policy, Tufts University.; Stephen Vosti – University of California-Davis; Devika Suri – Friedman School of Nutrition Science and Policy, Tufts University; Breanne Langlois – Friedman School of Nutrition Science and Policy, Tufts University; Beatrice Rogers – Friedman School of Nutrition Science and Policy, Tufts University

Ye Shen

Data Analyst/ Cost Specialist
Friedman School of Nutrition Science and Policy, Tufts University
Somerville, Massachusetts