Use of Optimization Modeling for Selecting National Micronutrient Intervention Strategies: An Example Based on Potential Programs for Control of Vitamin A Deficiency in Cameroon
Use of Optimization Modeling for Selecting National Micronutrient Intervention Strategies: An Example Based on Potential Programs for Control of Vitamin A Deficiency in Cameroon
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DOI：
10.1177/0379572115599325
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发表时间：
2015-09-01
影响因子：
1.9
通讯作者：
Vosti, Stephen A.
中科院分区：
文献类型：
--
作者：
Brown, Kenneth H.;Engle-Stone, Reina;Vosti, Stephen A.
维生素和矿物质（微量营养素[MN]）缺乏在低收入国家很常见，特别是在幼儿和育龄妇女中。由于这些缺陷的高流行率及其相关并发症，包括免疫功能下降、感染风险和严重程度增加、神经认知发育受损和贫血，这些共同导致死亡率升高和人类生产能力下降，因此引起严重关切。广泛的不同干预策略可用于控制锰缺乏。目前，这些干预措施通常是通过不同的公共和私营部门实体在国家范围内实施的，往往缺乏协调。我们根据不同干预措施实现有效覆盖的估计能力和部署这些干预措施所需的必要财政资源，开发了一套模型。这些模型提供了一个统一和透明的框架，以便使用有效覆盖率这一共同指标来考虑不同的选择。更具体地说，利用经济优化模型分析有关营养效益和成本的信息，以确定可以向特定地理区域的特定目标群体提供的干预措施组合，以最低成本实现所需的有效覆盖水平。或者，可以开发这些优化模型，以确定在特定预算限制下实现最大有效覆盖所需的干预措施组合。这些模型的结果可为决策过程提供有用的资料。为了介绍这种分析方法，本卷中的一组论文解决了喀麦隆幼儿维生素A缺乏症的问题。
Vitamin and mineral (micronutrient [MN]) deficiencies are common in lower income countries, especially among young children and women of reproductive age. These deficiencies are cause for serious concern because of their high prevalence and their associated complications, which include depressed immune function and increased risk and severity of infections, impaired neurocognitive development, and anemia, which together result in elevated mortality and reduced human productive capacity. A broad range of different intervention strategies are available to control MN deficiencies. At present, these interventions are usually implemented at a national scale through different public and private sector entities, often with little coordination. We have developed a set of models based on the estimated ability of different interventions to achieve effective coverage and the necessary financial resources required to deploy these interventions. The models provide a unified and transparent framework for considering different options using the common indicator of effective coverage. More specifically, information on nutritional benefits and costs are analyzed using an economic optimization model to identify the mix of interventions that could be delivered to specific target groups in particular geographic areas to achieve a desired level of effective coverage at lowest cost. Alternatively, these optimization models can be developed to identify the combination of interventions needed to achieve the maximum effective coverage, given specified budgetary limitations. The results of these models can be useful input into policy-making processes. To introduce this analytical approach, the set of papers in this volume addresses the problem of vitamin A deficiency among young children in Cameroon.