Peer-reviewed article
Cost analysis of probiotic/synbiotic supplementation in infants in rural Kenya: a study from the PROSYNK trial.
McCallum B, Iwaret Otiti M, Achieng F, Allen S, Worrall E ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study analyzes the costs of delivering probiotic and synbiotic supplements to infants aged 0-5 months in rural Kenya as part of the PROSYNK trial. The intervention aims to improve gut health and infant growth, addressing undernutrition which contributes to nearly half of deaths in children under 5. Trial costs were US$701.61 per infant, but if delivered through Kenya's Ministry of Health using community-based methods without cold chain requirements, programmatic costs could be reduced to US$9.14 per infant. The researchers conclude that probiotic/synbiotic delivery appears feasible and cost-comparable to existing nutrition interventions in Kenya.
Key points
- Trial delivery cost was US$701.61 per participant under research conditions
- Estimated programmatic cost through Kenya's Ministry of Health: US$9.14 per infant for full course
- Community-based delivery without cold chain is proposed as feasible implementation model
- Pro/synbiotics administered daily for first 10 days then weekly until 6 months
- Undernutrition underlies approximately 45% of global deaths in children under 5
Limitations
This is a cost analysis study conducted within a trial context; it does not evaluate the actual health effectiveness of the intervention or whether cost reductions in programmatic scenarios would be achieved in practice. The study provides projections rather than evidence of real-world implementation costs.
Abstract
Background Undernutrition significantly contributes to infant mortality and underlies approximately 45% of global deaths in children under 5, making it one of the most concerning global child health issues. The PRObiotics and SYNbiotics in infants in Kenya (PROSYNK) trial is assessing whether supervised pro/synbiotic doses daily for the first 10 days and then weekly to age 6 months has a positive impact on gut health and thereby growth and nutrition. This study provides a cost analysis of the PROSYNK trial, estimates the costs of implementing the intervention, and offers feasability insights for delivering it to infants 0-5 months in rural Kenya. Methods This provider perspective costing study used a combination of the ingredients approach, activity-based costing and microcosting. First, an empirical cost analysis of the PROSYNK trial was conducted by review of trial documentation and time and motion observations. Next, semistructured interviews with key informants informed a thematic analysis of implementation feasibility and the development of a theoretical programme structure, which formed the basis for estimating total economic programme costs. Results The economic cost of delivering the full pro/synbiotics course under trial conditions was measured as US$701.61 per participant. Experience gained during PROSYNK and discussions with key informants suggest that it could be feasible for the Ministry of Health (MoH) to implement programmatic delivery of the pro/synbiotics, particularly through community-based delivery, without a cold chain and with pro/synbiotic administered directly into infants' mouths. Incremental economic costs to the MoH of delivering the pro/synbiotic programmatically were estimated to be US$9.14 per infant per full course under the baseline scenario. Conclusion Pro/synbiotic administration in early life may be feasible and bear similar costs to existing nutrition interventions. This study will provide policy makers and stakeholders with cost and feasibility insights to inform effective programmatic implementation in Kenya and similar settings.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Supervised probiotic/synbiotic supplementation daily for first 10 days then weekly until 6 months of age
- Population
- Infants aged 0-5 months in rural Kenya
Key finding
Trial delivery cost: US$701.61 per participant