OBJECTIVES This study aims to evaluate the economic efficiency of a nutrition management program for children under 5 years of age in Kenge, Kwango District, Democratic Republic of the Congo (DR Congo) from 2014 to 2016. METHODS The economic efficiency of a nutrition management program for children under 5 years of age who have recovered from malnutrition status was evaluated using a cost-benefit analysis. The costs were analyzed according to the executed budget incurred during the project period. The benefits were estimated as the monetary value of the saved lives of children under 5 years of age. The economic efficiency of the program was determined by the Benefit-Cost Ratio (BCR). The BCR was calculated by dividing the total discounted benefit by the total discounted costs. The project is economically efficient when the BCR is greater than 1. RESULTS The costs of the nutrition management program were calculated as 1,677,609,648 Korean Won (KRW). A total of 2,466 children survived with improved malnutrition status through this program. The benefit for the reduction of mortality for children under 5 years of age was estimated to be 6,814,354,467 KRW, the estimated value of life for 2,466 children. The BCR was 4.06. CONCLUSIONS The nutrition management program for children under 5 years of age in DR Congo was found to be a cost-effective project. Successful and efficient Official Development Assistance (ODA) for a health project requires integrated and comprehensive strategies and specialized international development consulting to improve efficiency. Future nutrition management programs should take into account the national health program to maintain the sustainability of the project.
It is well established that excessive sodium intake is related to a higher incidence of chronic diseases such as hypertension, stroke, coronary heart disease, cardiovascular disease and gastric cancer. Although the upper limit of the current sodium intake guideline by WHO is set at 2,000 mg/day for adults, sodium intake of Koreans is well over 4,700 mg/capita/day implying an urgent need to develop and implement sodium intake reduction policy at the national level. This study investigated the cost-effectiveness of the sodium intake reduction policy, for the first time, in Korea. Analyses were performed using most recent and representative data on national health insurance statistics, healthcare utilization, employment information, disease morbidity/mortality, etc. The socioeconomic benefits of the policy, resulting from reduced morbidity of those relevant diseases, included lower medical expenditures, transportation costs, caregiver cost for inpatients and income losses. The socioeconomic benefits from diminished mortality included reductions in earning losses and welfare losses caused by early deaths. It is estimated that the amount of total benefits of reducing sodium intake from 4.7 g to 3.0 g is 12.6 trillion Korean Won; and the size of its cost is 149 billion Won. Assuming that the effect of sodium intake reduction would become gradually evident over a 5-year period, the implied rate of average return to the sodium reduction policy is 7,790% for the following 25 years, suggesting a very high cost-effectiveness. Accordingly, development and implementation of a mid-to-long term plan for a consistent sodium intake reduction policy is extremely beneficial and well warranted.
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