Systematic review of economic evaluation of early-life nutrition interventions to promote healthy eating during the first 1000 days.

objectiveTo identify economic evidence and evaluation for early-life interventions promoting healthy eating in the first 1000 days and to establish evidence gaps.

designFive databases and five websites were searched using key words. Findings were synthesised narratively.

settingHome, education and community settings.

participantsPregnant women, infants and young children aged 0-2 years.

resultsTwenty-four English-language, peer-reviewed economic evaluations reporting costs and consequences were selected. Overall, included studies demonstrated mixed quality. Using the Consolidated Health Economic Evaluation Reporting Standard (CHEERS) 2022, titles, comparators and outcomes were commonly reported, whereas health economic analysis plan (HEAP), heterogeneity and uncertainty were least reported. Four studies stated the analytical perspectives with clear decision contexts, making the results useful in decision-making. Several studies had a time horizon of one year or shorter with unclear decision context. Four studies presented relatively transparent methods, with the interpretation of results from cost-utility analyses being informative for decision-making.

conclusionsThis review identified consistent methodological challenges in the economic evaluation of early-life nutrition interventions. Comparators were inconsistently defined, and most studies adopted short time horizons, limiting assessment of longer-term outcomes. Chosen outcomes were focused on immediate health outcomes, with limited consideration of broader impacts or population differences. More robust and transparent approaches to economic evaluations, supported by a HEAP could improve consistency and support evidence-based decision-making.