{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T05:00:54Z","timestamp":1769230854843,"version":"3.49.0"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T00:00:00Z","timestamp":1624492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","award":["AID\u2010OAA\u2010A\u201011\u201000031"],"award-info":[{"award-number":["AID\u2010OAA\u2010A\u201011\u201000031"]}],"id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["nyaspubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of the New York Academy of Sciences"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Micronutrient powder (MNP) can reduce iron deficiency in young children, which has been well established in efficacy trials. However, the cost of different delivery platforms has not been determined. We calculated the cost and cost\u2010efficiency of distributed MNP through community\u2010based mechanisms and in health facilities in a primarily rural district in Uganda. An endline survey (<jats:italic>n\u00a0=\u00a0<\/jats:italic>1072) identified reach and adherence. During the 9\u2010month pilot, 37,458 (community platform) and 12,390 (facility platform) packets of MNP were distributed. Each packet consisted of 30 MNP sachets. In 2016, total costs were $277,082 (community platform, $0.24\/sachet) and $221,568 (facility platform, $0.59\/sachet). The cost per child reached was lower in the community platform ($53.24) than the facility platform ($65.97). The cost per child adhering to a protocol was $58.08 (community platform) and $72.69 (facility platform). The estimated cost of scaling up the community platform pilot to the district level over 3 years to cover approximately 17,890 children was $1.23 million (scale\u2010up integrated into a partner agency program) to $1.62 million (government scale\u2010up scenario). Unlike previous estimates, these included opportunity costs. Community\u2010based MNP delivery costs were greater, yet more cost\u2010efficient per child reached and adhering to protocol than facility\u2010based delivery. However, total costs for untargeted MNP delivery under program settings are potentially prohibitive.<\/jats:p>","DOI":"10.1111\/nyas.14621","type":"journal-article","created":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T04:41:02Z","timestamp":1624596062000},"page":"28-39","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Comparing costs and cost\u2010efficiency of platforms for micronutrient powder (MNP) delivery to children in rural Uganda"],"prefix":"10.1111","volume":"1502","author":[{"given":"Whitney","family":"Schott","sequence":"first","affiliation":[{"name":"Population Studies Center University of Pennsylvania Philadelphia Pennsylvania"},{"name":"A.J. Drexel Autism Institute Drexel University Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Belinda","family":"Richardson","sequence":"additional","affiliation":[{"name":"International Agricultural Development, Department of Plant Sciences University of California, Davis Davis California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Baker","sequence":"additional","affiliation":[{"name":"International Agricultural Development, Department of Plant Sciences University of California, Davis Davis California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexis","family":"D'Agostino","sequence":"additional","affiliation":[{"name":"County of Santa Clara Public Health Department San Jose California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sorrel","family":"Namaste","sequence":"additional","affiliation":[{"name":"The DHS Program ICF Rockville Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen A.","family":"Vosti","sequence":"additional","affiliation":[{"name":"Department of Agricultural and Resource Economics University of California\u2010Davis Davis California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,24]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"World Health Organization.Malnutrition. Fact Sheet 2020. Accessed March 29 2021.https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/malnutrition."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60937-X"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60996-4"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-2828G"},{"issue":"1","key":"e_1_2_8_6_1","doi-asserted-by":"crossref","first-page":"402S","DOI":"10.3945\/ajcn.116.142323","article-title":"Predictors of anemia in preschool children: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project","volume":"106","author":"Engle\u2010Stone R.","year":"2017","journal-title":"Am. J. Clin. Nutr."},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2015.11.002"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S72491"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000480742"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2015.4276"},{"key":"e_1_2_8_11_1","unstructured":"World Health Organization.Iron deficiency anaemia: assessment prevention and control: a guide for programme managers.2001."},{"key":"e_1_2_8_12_1","unstructured":"Armstrong A.L.2009.Anemia in Central\u2010Asia pre\u2010school children: definition risk factors and evaluation of home fortification intervention."},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/136.4.1068"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.3945\/jn.110.137182"},{"key":"e_1_2_8_15_1","first-page":"CD008959","article-title":"Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age","volume":"2","author":"Suchdev P.S.","year":"2020","journal-title":"Cochrane Database Syst. 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Accessed March 24 2020.https:\/\/www.advancingnutrition.org\/sites\/default\/files\/2020\u201002\/spring\u2010cost\u2010efficiency\u2010mnp\u2010dist\u2010brief.pdf."},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.3945\/cdn.117.001123"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czu055"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0191549"},{"key":"e_1_2_8_28_1","doi-asserted-by":"crossref","first-page":"e13111","DOI":"10.1111\/mcn.13111","article-title":"Determinants of adherence to micronutrient powder use among young children in Ethiopia","volume":"17","author":"Samuel A.","year":"2020","journal-title":"Matern. 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