{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T12:36:23Z","timestamp":1770813383323,"version":"3.50.1"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2019,8,29]],"date-time":"2019-08-29T00:00:00Z","timestamp":1567036800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"International Potato Center"},{"name":"Sweetpotato Action for Security and Health in Africa"},{"DOI":"10.13039\/100000865","name":"Bill & Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP53344"],"award-info":[{"award-number":["OPP53344"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Integrated nutrition and agricultural interventions have the potential to improve the efficiency and effectiveness of investments in food security and nutrition. This article aimed to estimate the costs of an integrated agriculture and health intervention (Mama SASHA) focused on the promotion of orange-fleshed sweet potato (OFSP) production and consumption in Western Kenya. Programme activities included nutrition education and distribution of vouchers for OFSP vines during antenatal care and postnatal care (PNC) visits. We used expenditures and activity-based costing to estimate the financial costs during programme implementation (2011\u201313). Cost data were collected from monthly expense reports and interviews with staff members from all implementing organizations. Financial costs totalled US$507\u00a0809 for the project period. Recruiting and retaining women over the duration of their pregnancy and postpartum period required significant resources. Mama SASHA reached 3281 pregnant women at a cost of US$155 per beneficiary. Including both pregnant women and infants who attended PNC services with their mothers, the cost was US$110 per beneficiary. Joint planning, co-ordination and training across sectors drove 27% of programme costs. This study found that the average cost per beneficiary to implement an integrated agriculture, health and nutrition programme was substantial. Planning and implementing less intensive integrated interventions may be possible, and economies of scale may reduce overall costs. Empirical estimates of costs by components are critical for future planning and scaling up of integrated programmes.<\/jats:p>","DOI":"10.1093\/heapol\/czz083","type":"journal-article","created":{"date-parts":[[2019,8,22]],"date-time":"2019-08-22T15:31:55Z","timestamp":1566487915000},"page":"646-655","source":"Crossref","is-referenced-by-count":15,"title":["What is the cost of integration? Evidence from an integrated health and agriculture project to improve nutrition outcomes in Western Kenya"],"prefix":"10.1093","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7691-0172","authenticated-orcid":false,"given":"Carol E","family":"Levin","sequence":"first","affiliation":[{"name":"Department of Global Health, University of Washington, NJB Box #359931, 325 Ninth Avenue, Seattle, WA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie L","family":"Self","sequence":"additional","affiliation":[{"name":"Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellah","family":"Kedera","sequence":"additional","affiliation":[{"name":"Path, Bungoma, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moses","family":"Wamalwa","sequence":"additional","affiliation":[{"name":"International Potato Center, Bungoma, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia","family":"Hu","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick","family":"Grant","sequence":"additional","affiliation":[{"name":"International Potato Center, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy Webb","family":"Girard","sequence":"additional","affiliation":[{"name":"Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald C","family":"Cole","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan W","family":"Low","sequence":"additional","affiliation":[{"name":"International Potato Center, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,8,29]]},"reference":[{"key":"2019112706503751200_czz083-B1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/heapol\/czp053","article-title":"A systematic review of the evidence on integration of targeted health interventions into health systems","volume":"25","author":"Atun","year":"2010","journal-title":"Health Policy and Planning"},{"key":"2019112706503751200_czz083-B2","first-page":"22","article-title":"A large-scale model for delivering homestead horticultural technologies in Bangladesh","volume":"2","author":"Baker","year":"1996","journal-title":"Micronutrients and Agriculture"},{"key":"2019112706503751200_czz083-B3","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/S0140-6736(13)60996-4","article-title":"Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost?","volume":"382","author":"Bhutta","year":"2013","journal-title":"The Lancet"},{"key":"2019112706503751200_czz083-B300","doi-asserted-by":"crossref","first-page":"852","DOI":"10.3945\/an.115.010348","article-title":"Integrating nutrition and child development interventions: scientific basis, evidence of impact, and implementation considerations","volume":"6","author":"Black","year":"2015","journal-title":"Advances in Nutrition"},{"key":"2019112706503751200_czz083-B4","year":"2013"},{"key":"2019112706503751200_czz083-B5","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.evalprogplan.2016.03.001","article-title":"Planning an integrated agriculture and health program and designing its evaluation: experience from Western Kenya","volume":"56","author":"Cole","year":"2016","journal-title":"Evaluation and Program Planning"},{"key":"2019112706503751200_czz083-B6","volume-title":"Cost Analysis in Primary Health Care. 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