Societal Costs of Micronutrient Deficiencies in 6- to 59-month-old Children in Pakistan Food and Nutrition Bulletin

Oct 25, 2017

The burden of micronutrient deficiencies of children to the Pakistan society has been published 1 October 2017 in the Food and Nutrition Bulletin. The study estimates the health and economic consequences of the deficiencies of iodine, iron, vitamin A and zinc among ½ to <5 year-old children. The prevalence of these deficiencies in 2011 was high among Pakistani children: 43.8% iron deficiency anemia, 54.0% vitamin A and 39.2% zinc deficiency.

The economic model presented in this article considers the consequences the children with deficiencies and their families face over a lifetime: (1) economic consequences expressed in monetary terms including medical costs and future income losses (lower productivity) and (2) health consequences for their quality of life expressed in disability adjusted life years (DALYs). The calculation not only considers the entire age-group as a whole, but also separates the 6-<24 months and 24-59 months old subgroups. It is well documented that micronutrient deficiencies among infants under 2 years of age, in particular iron deficiency anemia, has the most severe and irreversible consequences on a child’s cognitive development later on in life. Furthermore different socio-economic population groups are affected to different degrees with micronutrient deficiencies. Therefore the analysis also calculates the economic and health burden for ten different socioeconomic strata.

The study found that based on available evidence between the link of these four micronutrient deficiencies and their health consequences the total burden to the Pakistan society in monetary terms was US$46 million medical costs and US$3,222 million production losses. This corresponds with ~1.44% of the GDP of the country in 2013. The total burden in lost quality of life was 3.4 million DALYs, which means that 3.4 million life years could have been saved without disability or in the absence of premature death if children would not have suffered from iron, iodine, vitamin A and zinc deficiencies. This figure represents 4.45% of the overall health burden expressed in DALYs in Pakistan. The bulk of the economic and health burden is linked to impaired cognitive development as a result of iron deficiency anemia among 6- to 23-month-old children and the premature mortality associated with vitamin A deficiency. The consequences are substantially higher for poorer households.

The calculated burden (economic and health) could be eliminated through nutritional and other public health interventions targeting 6-to 59-month-old children. These results can help to the design cost-effective interventions to reduce micronutrient deficiencies in early childhood and avoid their life-long consequences.