Cost effectiveness of responsive stimulation and nutrition interventions on early child development outcomes in Pakistan

Saima Gowani, Aisha K. Yousafzai, Robert Armstrong, Zulfiqar A. Bhutta

Research output: Contribution to journalArticlepeer-review

35 Citations (Scopus)

Abstract

Early childhood programs are heralded as a way to improve children's health and educational outcomes. However, few studies in developing countries calculate the effectiveness of quality early childhood interventions. Even fewer estimate the associated costs of such interventions. The study here looks at the costs and effectiveness of a cluster-randomized effectiveness trial on children from birth to 24 months in rural Sindh, Pakistan. Responsive stimulation and/or enhanced nutrition interventions were integrated in the Lady Health Worker program in Pakistan. Outcomes suggest that children who receive responsive stimulation had significantly better development outcomes at 24 months than those who only received enhanced nutrition intervention. A cost-effectiveness analysis of the results verifies that early childhood interventions that include responsive stimulation are more cost effective than a nutrition intervention alone in promoting children's early development. Costs of a responsive stimulation intervention integrated in an existing community-based service providing basic health and nutrition care is approximately US$4 per month per child. We discuss these findings and make recommendations about scaling up and costs for future early child development programs.

Original languageEnglish
Pages (from-to)149-161
Number of pages13
JournalAnnals of the New York Academy of Sciences
Volume1308
Issue number1
DOIs
Publication statusPublished - Jan 2014

Keywords

  • Cost effectiveness
  • Early childhood development
  • Nutrition
  • Pakistan
  • Responsive stimulation

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