Peer-reviewed article
A cost analysis comparing seasonal malaria chemoprevention with and without Vitamin A supplementation among under-5 children in Nigeria.
Oresanya OB, Arije O, Fadipe J, Rotimi K, Phillips A et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study compares the costs of delivering seasonal malaria chemoprevention (SMC) alone versus combined with vitamin A supplementation to children under 5 in Nigeria. The integrated approach cost $1.18 per child compared to $0.94 for SMC alone, representing an additional $0.24 per child. Distribution and drug costs were the largest cost drivers in both campaigns. The authors conclude that integrating vitamin A into SMC campaigns is feasible from a cost perspective and could help reduce child mortality from malaria and malnutrition.
Key points
- SMC-only campaign cost $0.94 per child; SMC plus vitamin A cost $1.18 per child
- Integration added US$27,492 to total costs across approximately 170,000 children reached
- Distribution and drug costs (SPAQ medication) were the largest cost components
- Fluctuations in distribution costs had the most significant effect on cost per child in sensitivity analysis
- The modest cost increment of $0.24 per child supports feasibility of integrated delivery
Limitations
This is a cost analysis only and does not evaluate health outcomes or cost-effectiveness of the interventions. The study was conducted in one region (Bauchi State, Northeast Nigeria) and may not be generalizable to other settings or seasons.
Abstract
Background Child mortality in Nigeria, significantly affected by malaria and malnutrition, remains a public health concern in the country. Seasonal Malaria Chemoprevention (SMC) and Vitamin A supplementation (VAS) are effective interventions that can be delivered through integrated health campaigns to reduce this mortality. This study assesses the cost implications of integrating these two interventions among under-5 children in Northeast Nigeria. Methods A cost analysis compared standalone SMC (Cycle 1 in July 2021) with SMC-VAS integrated campaign (Cycle 4 in October 2023) in two Local Government Areas (LGAs) in Bauchi State. The number of children reached by the SMC-only campaign was 168,820 and for the SMC + Vit A campaign, the number was 170,681. Data collection utilized a mixed-methods approach, drawing from primary and secondary sources, including programmatic, financial, and coverage records. Costs were categorized into distribution, Sulphadoxine-Pyrimethamine plus Amodaiquine (SPAQ) for SMC, Vitamin A, training, supplies, meetings, labor, supervision, and social mobilization costs. Sensitivity analyses evaluated the effect of a 10% fluctuation in the costs of distribution, labor, SPAQ, and supplies on the cost per child. Results The total cost for the SMC standalone campaign was US$158,934, and the SMC-VAS integration was US$186,426. Distribution and drug costs were the largest contributors in the integrated and SMC-only campaign. The SMC-only cost per child was $0.94 and $1.18 when eligible children received both SMC and VAS. The integration of VAS into the SMC campaign cycle incurred an additional US$27,492 over Cycle 1 cost (US$186,426 - US$158,934). Fluctuations in distribution costs were the most influential component of the cost per child. Conclusion Integrating VAS with SMC campaigns increases the cost by US$0.24 per child, a modest increment considering the potential health benefits. The results support the feasibility of this integration, in terms of cost, to combat child mortality from malaria and malnutrition in Nigeria. Further research is recommended to explore the cost-effectiveness of this integrated distribution model.