Cost-benefit analysis of a multicomponent breastfeeding promotion and support intervention in a developing country.
Cost-benefit analysis of a multicomponent breastfeeding promotion and support intervention in a developing country.
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发展中国家多成分母乳喂养促进和支持干预的成本效益分析。
DOI：
10.1101/2023.11.17.23298704
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Nabulsi,Mona
中科院分区：
文献类型：
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作者：
Basbous,Maya;Yehya,Nadine;Salti,Nisreen;Tamim,Hani;Nabulsi,Mona
背景母乳喂养的促进和支持干预的研究表明，一些经济效益。这项研究评估了直接和间接成本的多成分母乳喂养的促进和支持干预在头两年的婴儿的生命。对一项随机对照试验产生的数据进行效益分析，该试验调查了与标准母乳喂养相比，在产后前六个月向黎巴嫩母亲提供多组分母乳喂养促进和支持干预是否会提高母乳喂养率产科和儿科护理。339名参与者的社会人口统计学、母婴健康、婴儿营养、干预的直接和间接成本数据被用来评估干预在1个月、6个月、12个月和24个月时的效益成本比（BCR）作为主要结局。次要结果包括婴儿营养的总成本和婴儿-母亲二元健康成本在头两年。多元线性回归模型探讨了干预对婴儿总体营养成本和母婴健康成本的影响。类似的回归模型调查了成本变量与婴儿营养类型（纯母乳喂养，混合喂养，人造奶）之间的关系。使用SPSS（第24版）进行意向治疗分析。结果母乳喂养率从第一个月的51.6%下降到第二年的6.6%。在前六个月，多组分母乳喂养干预比对照组多花费485美元，但在一年（增量净收益为374美元; BCR = 2.44）和两年（增量净收益为472美元; BCR = 2.82）时具有成本效益。在调整分析中，干预与第一年婴儿疾病就诊次数减少显著相关（p= 0.045）。按婴儿营养类型进行的分层分析显示，与仅接受人工奶的婴儿相比，在头两年的不同时间点，接受纯母乳喂养/主要母乳喂养或任何母乳喂养的婴儿的健康结果显著更有利（p<0.05），其中纯母乳喂养/主要母乳喂养组的健康益处最高。此外，纯母乳喂养/母乳喂养和任何母乳喂养组在两年内婴儿疾病就诊、住院和婴儿药物治疗的费用显著降低（p<0.05），但由于母乳喂养，母亲非常规医生就诊的费用增加（所有p值均<0.05）。而总成本（直接和间接）在头六个月是显着降低的theExclusive/Predominantbreastfeeding婴儿（p= 0.001），他们是类似的婴儿对混合喂养或人工Milk.ConclusionsBreastfeeding是与显着的经济和婴儿健康的好处，在头两年。在当前黎巴嫩经济危机的背景下，这项研究为决策者提供了进一步的证据，说明有必要投资于国家母乳喂养促进和支持干预措施。
BackgroundStudies on breastfeeding promotion and support interventions suggest some economic benefits. This study assessed the direct and indirect costs of a multicomponent breastfeeding promotion and support intervention during the first two years of the infant’s life.MethodsThis is a cost-benefit analysis of data generated from a randomized controlled trial that investigated whether provision of a multicomponent breastfeeding promotion and support intervention to Lebanese mothers in the first six months postpartum would improve breastfeeding rates compared to standard obstetric and pediatric care. Data of 339 participants on sociodemographics, mother and infant health, infant nutrition, direct and indirect costs of the intervention were used to assess the benefit-cost ratio (BCR) of the intervention at one, six, 12, and 24 months as primary outcome. Secondary outcomes included overall costs of infant nutrition and infant-mother dyad health costs during the first two years. Multiple linear regression models explored the effect of the intervention on the overall infant nutrition cost and mother-infant health costs. Similar regression models investigated the association between cost variables and infant nutrition types (exclusive breastfeeding, mixed feeding, artificial milk). Intention to treat analyses were conducted using SPSS (version 24). Statistical significance was set at ap-value below 0.05.ResultsThe prevalence ofExclusive/Predominantbreastfeeding among participants declined from 51.6% in the first month to 6.6% at the end of second year. The multicomponent breastfeeding intervention incurred 485 USD more in costs than the control group during the first six months but was cost-efficient at one year (incremental net benefits of 374 USD; BCR = 2.44), and two years (incremental net benefits of 472 USD; BCR = 2.82). In adjusted analyses, the intervention was significantly associated with fewer infant illness visits in the first year (p= 0.045). Stratified analyses by the infant nutrition type revealed that infants who were onExclusive/Predominant, orAny Breastfeedinghad significantly more favorable health outcomes at different time points during the first two years (p<0.05) compared to infants receivingArtificial Milkonly, with health benefits being highest in theExclusive/Predominantbreastfeeding group. Moreover,Exclusive/PredominantandAny Breastfeedinghad significantly lower costs of infant illness visits, hospitalizations, and infant medications during the two years (p<0.05) but had additional cost for maternal non-routine doctor visits due to breastfeeding (allpvalues <0.05). Whereas the overall cost (direct and indirect) during the first six months was significantly lower for theExclusive/Predominantbreastfeeding infants (p= 0.001), they were similar in infants onMixed FeedingorArtificial Milk.ConclusionsBreastfeeding is associated with significant economic and infant health benefits in the first two years. In the context of the current economic crisis in Lebanon, this study provides further evidence to policymakers on the need to invest in national breastfeeding promotion and support interventions.