An Investment Framework for Nutrition: Reaching the Global Targets for Stunting, Anemia, Breastfeeding, and Wasting estimates the costs, impacts, and financing scenarios to achieve the World Health Assembly global nutrition targets for stunting, anemia in women, exclusive breastfeeding and the scaling up of the treatment of severe wasting among young children. To reach these four targets, the world needs US$70 billion over 10 years to invest in high-impact nutrition-specific interventions. This investment would have enormous benefits: 65 million cases of stunting and 265 million cases of anemia in women would be prevented in 2025 as compared with the 2015 baseline. In addition, at least 91 million more children would be treated for severe wasting and 105 million additional babies would be exclusively breastfed during the first six months of life over 10 years. Altogether, achieving these targets would avert at least 3.7 million child deaths. Every dollar invested in this package of interventions would yield between US$4 and US$35 in economic returns, making investing in early nutrition one of the best value-for-money development actions. Although some of the targets—especially those for reducing stunting in children and anemia in women—are ambitious and will require concerted efforts in financing, scale-up, and sustained commitment, recent experience from several countries suggests that meeting these targets is feasible. These investments in the critical 1000-day window of early childhood are inalienable and portable and will pay lifelong dividends—not only for children directly affected but also for us all in the form of more robust societies—that will drive future economies.

An Investment Framework for Nutrition: Reaching the Global Targets for Stunting, Anemia, Breastfeeding, and Wasting estimates the costs, impacts, and financing scenarios to achieve the World Health Assembly global nutrition targets for stunting, anemia in women, exclusive breastfeeding and the scaling up of the treatment of severe wasting among young children. To reach these four targets, the world needs US$70 billion over 10 years to invest in high-impact nutrition-specific interventions. This investment would have enormous benefits: 65 million cases of stunting and 265 million cases of anemia in women would be prevented in 2025 as compared with the 2015 baseline. In addition, at least 91 million more children would be treated for severe wasting and 105 million additional babies would be exclusively breastfed during the first six months of life over 10 years. Altogether, achieving these targets would avert at least 3.7 million child deaths. Every dollar invested in this package of interventions would yield between US$4 and US$35 in economic returns, making investing in early nutrition one of the best value-for-money development actions. Although some of the targets--especially those for reducing stunting in children and anemia in women--are ambitious and will require concerted efforts in financing, scale-up, and sustained commitment, recent experience from several countries suggests that meeting these targets is feasible. These investments in the critical 1000-day window of early childhood are inalienable and portable and will pay lifelong dividends--not only for children directly affected but also for us all in the form of more robust societies--that will drive future economies.

This paper examines the costs, impacts, and cost-effectiveness of scaling up over five years the nutrition interventions included in Afghanistan's Basic Package of Health Services (BPHS) as a first step in investing in the early years to build human capital. The total public investment required for the scale up to government-set program coverage levels is estimated to be 44 million US dollars per year over five years, or 1.49 US dollars per capita per year. Each dollar invested would yield at least 13 US dollars in economic returns and even under conservative assumptions regarding future economic growth, the economic benefits exceed the cost by six times which is 815 million US dollars over the productive lives of the beneficiaries. This scale up would prevent almost 25,000 child deaths and over 4,000 cases of stunting and avert a loss of 640,000 disability-adjusted life years (DALYs) and almost 90,000 cases years of anemia. Almost 100,000 more children would be exclusively breastfed. However, this scale-up would only have a marginal effect, a decrease of less than one-half percentage point on stunting prevalence because the current government-set target program coverage rates are very low for the preventive interventions that affect stunting. A substantially greater impact could be achieved if preventive interventions could be scaled to full program coverage levels, which would require less than 5 million US dollars more a year. This would triple the number of DALYs averted, double the number of deaths averted and avert almost eight times as many cases of stunting, resulting in a 2.6 percentage point decline in stunting over the five year period (from 41 percent to 38 percent). The prevalence of anemia in pregnant women could be reduced by 12 percentage points and the prevalence of exclusive breastfeeding could be increased by 18 percentage points. In addition, this investment is projected to generate economic benefits of 815 million US dollars over the productive lives of the beneficiaries. Each dollar invested would yield more than 13 US dollars in economic returns. Sensitivity analysis was conducted for the total cost, cost-effectiveness, and economic returns on investing in the BPHS nutrition interventions.

This paper builds on global experience and Zambia's specific context to identify aneffective nutrition approach along with costs and benefits of key nutrition interventions. It isintended to help guide the selection of the most cost-effective interventions as well as strategiesfor scaling these up. The paper considers both relevant "nutrition-specific" interventions, largelydelivered through the health sector, and multisectoral "nutrition-sensitive" interventions, delivered through other sectors such as agriculture, education, and water and sanitation. We estimate that the costs and benefits of implementing 10 nutrition-specific interventions would require an annual public investment of USD 40.5 million and would avert over 112,000 DALYs, save over 2,800 lives, and prevent 62,000 cases of stunting. Economic productivity could potentially increase by USD 915 million annually over the productive lives of the beneficiaries, with an impressive internal rate of return of 32 percent. However, because it is unlikely that the Government of the Zambia or its partners will find the USD 40.5 million necessary each year to reach full coverage, we also consider scale-up scenarios based on considerations of their potential for impact, burden of stunting, resource requirements, and implementation capacity. The two scenarios that scale up the nine most cost-effective nutrition-specific interventions (excluding the public provision of complementary foods) are the most advantageous in terms of cost-effectiveness and resource requirements and would require USD 11 million to scale up to partial levels and USD 23 to scale up to full coverage levels. Among the 8 nutrition-specific interventions we consider, school-baseddeworming is low cost and effective. The interventions we reviewed in the agriculture sector areexpensive when compared to nutrition-specific interventions, although very little cost effectiveness data are available for the nutrition-sensitive interventions to make carefulcomparisons. These findings point to a powerful set of nutrition-specific interventions and acandidate list of nutrition-sensitive approaches that represent a highly cost-effective approach toreducing child malnutrition in Zambia.

This paper builds on global experience and Kenya's specific context to identify an effective approach to scaling up nutrition and provide an estimate of costs and benefits of key nutrition interventions. It is intended to help guide the selection of the most cost-effective interventions as well as strategies for scaling up a package of interventions tailored to Kenya's specific needs. The paper considers high-impact nutrition-specific interventions that largely rely on typical health sector delivery mechanisms. The authors estimate that the costs and benefits of implementing 11 critical nutrition-specific interventions will require a yearly public and donor investment of 76 million dollars. The expected benefits will be substantial: annually more than 455,000 disability adjusted life years (DALYs) will be averted, over 5,000 lives saved, and more than almost 700,000 cases of stunting among children under five averted. This investment will be very cost-effective with an estimated cost per DALY averted of 207 dollars cost per life saved of about 18,600 dollars and a cost per case of stunting averted of 135 dollars. Economic productivity can potentially increase by 458 million dollars over the productive lives of beneficiaries. However, the authors also calculate intermediate scale-up scenarios since it may not be feasible for the Government of Kenya or its partners to achieve full coverage in the near term. The authors compare the costs and benefits associated with three different scenarios: first, prioritizing counties, focusing the investment on counties with a high burden of stunting; second, prioritizing interventions, focusing on only a subset of the most effective interventions; and third, prioritizing both counties and interventions, delivering only the most effective subset of interventions to high-burden counties. The authors determined that the third scenario is the most cost-effective and least costly. Scaling up the most cost-effective interventions in 37 high-burden counties will avert almost 295,000 DALYs and save over 3,000 lives per year for an annual public and donor investment of 48 million dollars.

Ending malnutrition in all forms is a global development priority. Investment in nutrition can yield high returns in terms of reduced health costs, increased productivity and improved human resources capacity and economic growth (Covic & and Hendriks 2016; Shekar et al. 2017). Nutrition policy-making and program interventions in developing countries fail to bring together several sectors that contribute to nutrition improvement. Since food systems influence the type of food produced, understanding relevant drivers of a country’s food system with an emphasis on nutrition can help to end malnutrition (Per Pinstrup-Andersen 2012a; HLPE 2017; Babu and Kataki 2003). In this paper, we adopt a food systems perspective to review Myanmar’s current food system. With the help of a review of the literature and two national consultative stakeholder workshops, we examine Myanmar’s current food system. This is a crucial step since it identifies gaps existing in the current policies/ strategies being implemented. After the review, we developed an AIT (analyze gaps, identify priority investment areas, and track progress) operational framework that can be used to increase the nutrition-sensitivity of a food system. Applying this framework to Agriculture Development Strategy (ADS), this paper presents an analysis of the gaps that need to be addressed to make ADS nutrition-sensitive, provide priority investment areas, and a tracking system which monitors the progress of these investments.

This brief examines estimates produced by several recent model simulations and frameworks that focus on the cost of ending hunger as well as progress toward other development goals—estimates that range from US$7 billion to US$265 billion per year. The differences among these estimates are largely attributable to the different targeted objectives and policy questions of each modeling exercise, different investment strategies considered, and varying assumptions about the role of different sectors in reducing hunger.