Impact of scaling up prenatal nutrition interventions on human capital outcomes in low- and middle-income countries: a modeling analysis.
Am J Clin Nutr
; 114(5): 1708-1718, 2021 11 08.
Article
em En
| MEDLINE
| ID: mdl-34320177
ABSTRACT
BACKGROUND:
Prenatal nutrition interventions can lead to improved birth outcomes, which in turn are associated with better education and human capital outcomes later in life.OBJECTIVE:
We estimated the impact of scaling up iron-folic acid (IFA), calcium, multiple micronutrient (MMS), and balanced energy protein (BEP) supplementation for pregnant women, on human capital outcomes in low- and middle-income countries (LMIC).METHODS:
We used mathematical modeling with proportional reductions in adverse birth outcomes to estimate the potential gains in school years and lifetime income due to scaling up each prenatal nutrition intervention. Estimates of intervention effects on birth outcomes were derived from meta-analyses of randomized trials. Estimates of the associations between birth outcomes and schooling and lifetime income were derived from de novo meta-analyses of observational studies.RESULTS:
Across 132 LMIC, scaling up prenatal nutrition interventions to 90% coverage was estimated to increase school years and lifetime income per birth cohort by 2.28 million y (95% uncertainty intervals (UI) -0.44, 6.26) and $8.26 billion (95% UI -1.60, 22.4) for IFA; 4.08 million y (95% UI 0.12, 9.68) and $18.9 billion (95% UI 0.59, 44.6) for calcium; 5.02 million y (95% UI 1.07, 11.0) and $18.1 billion (95% UI 3.88, 39.1) for MMS; and 0.53 million y (95% UI -0.49, 1.70) and $1.34 billion (95% UI -1.10, 3.10 billion) for BEP supplementation. South Asia and Sub-Saharan Africa tended to have the largest estimated regional gains in school years for scaling up each intervention due to the large population size and high burden of poor birth outcomes. Absolute income benefits for each intervention were estimated to be the largest in Latin America, where returns to education and incomes are higher relative to other regions.CONCLUSION:
Increasing coverage of prenatal nutrition interventions in LMIC may lead to substantial gains in schooling and lifetime income. Decision makers should consider the potential long-term human capital returns of investments in maternal nutrition.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Fenômenos Fisiológicos da Nutrição Pré-Natal
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
Limite:
Female
/
Humans
/
Pregnancy
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article