{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T02:50:46Z","timestamp":1768272646875,"version":"3.49.0"},"reference-count":40,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2019,5,31]],"date-time":"2019-05-31T00:00:00Z","timestamp":1559260800000},"content-version":"vor","delay-in-days":30,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008627","name":"Global Affairs Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008627","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000193","name":"International Development Research Centre","doi-asserted-by":"publisher","award":["107790"],"award-info":[{"award-number":["107790"]}],"id":[{"id":"10.13039\/501100000193","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp; Child Nutrition"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In 2011, Tanzania mandated the fortification of edible oil with vitamin A to help address its vitamin A deficiency (VAD) public health problem. By 2015, only 16% of edible oil met the standards for adequate fortification. There is no evidence on the cost\u2010effectiveness of the fortification of edible oil by small\u2010 and medium\u2010scale (SMS) producers in preventing VAD. The MASAVA project initiated the production of sunflower oil fortified with vitamin A by SMS producers in the Manyara and Shinyanga regions of Tanzania. A quasi\u2010experimental nonequivalent control\u2010group research trial and an economic evaluation were conducted. The household survey included mother and child pairs from a sample of 568 households before the intervention and 18\u00a0months later. From the social perspective, the incremental cost of fortification of sunflower oil could be as low as $0.13, $0.06, and $0.02 per litre for small\u2010, medium\u2010, and large\u2010scale producers, respectively, compared with unfortified sunflower oil. The SMS intervention increased access to fortified oil for some vulnerable groups but did not have a significant effect on the prevention of VAD due to insufficient coverage. Fortification of vegetable oil by large\u2010scale producers was associated with a significant reduction of VAD in children from Shinyanga. The estimated cost per disability\u2010adjusted life year averted for fortified sunflower oil was $281 for large\u2010scale and could be as low as $626 for medium\u2010scale and $1,507 for small\u2010scale producers under ideal conditions. According to the World Health Organization thresholds, this intervention is very cost\u2010effective for large\u2010 and medium\u2010scale producers and cost\u2010effective for small\u2010scale producers.<\/jats:p>","DOI":"10.1111\/mcn.12720","type":"journal-article","created":{"date-parts":[[2019,5,31]],"date-time":"2019-05-31T07:42:50Z","timestamp":1559288570000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Cost\u2010effectiveness of sunflower oil fortification with vitamin A in Tanzania by scale"],"prefix":"10.1111","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9310-376X","authenticated-orcid":false,"given":"Dylan","family":"Walters","sequence":"first","affiliation":[{"name":"Canadian Centre for Health Economics, Institute of Health Policy, Management and Evaluation University of Toronto Toronto Ontario Canada"},{"name":"Nutrition International Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edna","family":"Ndau","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Consumer Sciences Sokoine University of Agriculture Morogoro Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadira","family":"Saleh","sequence":"additional","affiliation":[{"name":"MEDA Waterloo Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theobald","family":"Mosha","sequence":"additional","affiliation":[{"name":"Department of Food Technology, Nutrition and Consumer Sciences Sokoine University of Agriculture Morogoro Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Horton","sequence":"additional","affiliation":[{"name":"School of Public Health and Health Systems University of Waterloo Waterloo Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,5,31]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3945\/jn.116.245753"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/wbro\/10.1.1"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60996-4"},{"key":"e_1_2_10_5_1","unstructured":"Bill and Melinda Gates Foundation. (2014).Methods for economic evaluation project: The Gates reference case\u2014What it is why it's important and how to use it. Retrieved fromhttps:\/\/www.nice.org.uk\/Media\/Default\/About\/what\u2010we\u2010do\/NICE\u2010International\/projects\/MEEP\u2010report.pdf"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60937-X"},{"issue":"67","key":"e_1_2_10_7_1","first-page":"1","article-title":"Micronutrient fortification of food and its impact on woman and child health: A systematic review","volume":"2","author":"Das J. K.","year":"2013","journal-title":"Systematic Reviews"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780198529446.001.0001","volume-title":"Methods for the economic evaluation of health care programmes","author":"Drummond M. 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