Economic Evaluation: Costing participatory learning and action cycles with women’s groups to improve feeding, care and dental hygiene for South Asian infants in London

Abstract

Background The Nurture Early for Optimal Nutrition (NEON) programme was designed to promote equitable early childhood development by educating mothers of South Asian origin in east London on optimal feeding, care, and dental hygiene practices. This study conducts a cost analysis of the NEON programme and evaluates its financial sustainability. Methods We conducted an economic costing from the provider perspective and followed a stepdown procedure to identify all costs incurred from December 2019, the initiation of the trial, to May 2023, the completion of final evaluation and dissemination. Costs associated with start-up, implementation, and monitoring and evaluation activities are differentiated. Affordability analysis was conducted with respect to the budget of the local authorities. Results The total cost of NEON design and delivery in Newham and Towe Hamlets was 75,992 GBP ($INT 114,445), with 45% for staff salaries, 50% for material, and 5% for capital investment. The start-up stage cost 57% while the implementation stage cost 43%. The average cost per mother participating in the programme was 409 GBP ($INT 615). The total cost of trial delivery in Newham accounted for around 0.053% of the borough's annual child development expenditure, while the total trial cost in Tower Hamlets was equivalent to 0.003% of its' spending on children's development. Conclusion The delivery of NEON is largely within local authorities' budget for childhood development. The unit cost is expected to decrease when sharing costs are spread across more participants and implementing systems are validated and well developed.