Cost effectiveness of fortified bouillon in addressing Burkinabe children's vitamin A inadequacy: An economic optimization model.

Vitamin A dietary inadequacy remains a serious public health problem among young children 6-59 months of age in Burkina Faso. Planners face several interrelated challenges: Selecting concrete policy objectives regarding vitamin A inadequacy reductions, identifying cost-effective vitamin A intervention programs that can achieve those objectives, and being reasonably sure that proposed intervention programs are robust to uncertainty in program benefits and costs. A 10-year, subnational economic optimization model making use of secondary dietary intake data and program cost data was developed and implemented to address these issues and included the following vitamin A program options: existing or improved edible oils fortification, a pair of hypothetical vitamin A-fortified bouillon programs, and a set of subnational vitamin A supplementation (VAS) programs. The model consistently identified the improved edible oils and bouillon fortification programs as the core national programs upon which the more expensive subnational VAS programs could be layered, depending on policy objectives and available funding. These results were robust to uncertainty in program nutritional benefits and costs. However, even if the most impactful set of modeled programs was implemented, vitamin A inadequacy among children would remain a serious public health problem; hence, additional efforts to address it would be needed.