Strategies to address undernutrition in low- and middle-income countries (LMICs) include various interventions implemented through different sectors of the economy. Our aim is to provide an overview of published economic evaluations of such interventions and to compare and contrast evaluations of interventions in different areas. We reviewed economic evaluations of nutrition interventions in LMICs published since 2015 and/or included in the Tufts Global registry or Disease Control Priorities 3rd edition. We categorized the studies by intervention type (preventive; therapeutic; fortification; delivery platforms), nutritional deficiency addressed and characteristics of the economic evaluation (e.g. type of model, costs and outcomes included). Of the 62 economic evaluations identified, 56 (90%) were cost-effectiveness analyses. Twenty-two (36%) evaluations investigated fortification and 23 (37%) preventive interventions. Forty-three percentage of the evaluations of preventive interventions did not include a model, whereas most of fortification strategies used the same reference model. We identified different trends in cost categories and inclusion of health and non-health outcomes across evaluations in the four different topic areas. To illustrate the implications of such trends for decision-making, we compared a set of studies evaluating alternative strategies to combat zinc deficiency. We showed that the use of ‘off-the-shelf’ models and tools can potentially conceal what outcomes and costs and value judgements are used. Comparing interventions across different areas is fundamental to assist decision-makers in developing their nutrition strategy. Systematic differences in the economic evaluations of interventions delivered within and outside the health sector can undermine the ability to prioritize alternative nutrition strategies.
For many decades the worldwide expansion of supply and demand for skilled work has been at the heart of economic growth and development. In this paper, we use the 1991–2010 panel data from the Kagera Health and Development Survey in North West Tanzania to examine the work outcomes at the end of the panel of those who were young (7 to 24 years) in the baseline. First, we illustrate the significant extent to which advanced education and skilled work go hand in hand. We analyse specifically the baseline household factors enabling individuals to access more advanced education, and we find quite different results by gender. We then analyse, again by gender, how this education plus baseline characteristics matter for attaining skilled or professional work. We also study the importance of migration in the process and the degree of intergenerational mobility in skilled work. The results show vividly how some key household factors help young men advance in their education and career, while childcare in particular retards the progress young women can make.
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