Peer-reviewed article
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.
Zhang Y, Patil P, Chaudhary S, Kondhare KD, Faijue DD et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001The NEON programme in East London taught mothers of South Asian origin about optimal feeding, care, and dental hygiene practices for infants through participatory learning groups. The programme cost £439 per mother in face-to-face delivery and £407 online, representing less than 0.05% of local authority spending on child development. Mothers reported improved confidence and feeding practices, though attendance and retention dropped during COVID-19.
Key points
- Total programme cost was £68,165, with materials representing 50% of costs, staff 45%, and capital 5%
- Average cost per participating mother was £439 (face-to-face) or £407 (online)
- Intervention costs represented 0.047% of Newham's and 0.003% of Tower Hamlets' annual child development expenditure
- The adapted Participatory Learning and Action approach was highly acceptable to participants
- Improvements noted in maternal confidence and infant feeding practices, though attendance and retention challenges occurred particularly during COVID-19
Limitations
This is a costing study from the provider perspective that does not measure health or developmental outcomes for children. The analysis focuses on financial feasibility rather than effectiveness, and attendance challenges during COVID-19 may not reflect typical implementation costs.
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 two boroughs (Newham and Tower Hamlets) in East London on optimal feeding, care, and dental hygiene practices. The study found that the adapted Participatory Learning and Action (PLA) approach was highly acceptable and well-received by participants, with improvements in maternal confidence, infant feeding practices, and community engagement. However, gaps in specific feeding skills and challenges such as low attendance and retention rates were noted, particularly during the COVID-19 pandemic. This study conducted a cost analysis of the NEON programme and evaluated its financial sustainability. Methods We conducted a financial and economic costing from the provider perspective, applying a stepdown procedure to identify costs associated with the development and implementation of the NEON programme. Estimates of total and average costs per mother are presented along with affordability assessments, expressed as a proportion of the borough's annual child development expenditure. All costs were discounted and reported in 2022 pound sterling and in 2022 international dollars. Results The total cost of NEON design and delivery was £68,165 ($INT 102,658), and the average cost per mother participating in the programme was £439($INT 661) in the face-to face arm and £407($INT 614) in the online arm. The largest contributor to the total cost was materials (50%), including NEON training manuals and intervention toolkits, vouchers for the community facilitators, and overheads, followed by staff costs (45%) and capital investments (5%). The total cost of intervention delivery in Newham accounted for around 0.047% of the borough's annual child development expenditure, while the total intervention 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.