{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:34:17Z","timestamp":1785418457104,"version":"3.56.0"},"reference-count":41,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Anaemia prevalence among Southern African children aged 6\u201323 months was estimated at 65% in 2019. The World Health Organization recommends that children aged 6\u201323 months living in countries with an anaemia prevalence above 40% should receive preventive oral iron supplements.\nAim:\u00a0This study aimed to conduct a context-specific economic evaluation of oral iron supplementation in children aged 6 months \u2013 23 months for preventing iron deficiency and anaemia in South Africa (SA).\nMethod:\u00a0We undertook a cost-effectiveness analysis (CEA), comparing preventive iron supplementation with no supplementation. Using a 1-year time horizon, we took a provider perspective and used circulating haemoglobin as the effectiveness outcome. The incremental cost-effectiveness ratio (ICER) was calculated as the cost per disability-adjusted life year (DALY) because of anaemia averted. A budget impact analysis (BIA) was carried out to estimate start-up and total annual costs of intervention implementation in SA.\nResults:\u00a0The ICER (cost per DALY averted) was R1077.00 ($58.40); below a conservative context-relevant threshold (R62 916.00 [$3410.00]) (2024). Budget impact analysis estimated total costs over 2 years (2024\u20132025), excluding start-up costs, of R16.94 ($0.92) per child aged &lt; 2 years in SA, based on the CEA dosing regimen. Intervention costs (including start-up costs) represent 0.007% of the total health budget (2024).\nConclusion:\u00a0Preventive oral iron supplementation resulted in increased effectiveness for averting DALYs because of anaemia. Comparisons of the ICER with context-relevant thresholds suggested the intervention could be considered cost-effective in SA.\nContribution:\u00a0Our findings of potential cost-effectiveness and budget impact could be used to inform decision-making for primary healthcare resource allocation in SA\u2019s health system.<\/jats:p>","DOI":"10.4102\/phcfm.v18i1.5083","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T13:20:10Z","timestamp":1776259210000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Oral iron supplementation as a public health intervention in children aged 6 to 23 months for preventing iron deficiency and anaemia: Economic evaluation for the South African health system"],"prefix":"10.4102","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5504-1139","authenticated-orcid":false,"given":"Pamela","family":"Vorster","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05bk57929","id-type":"ROR","asserted-by":"publisher"}],"name":"Stellenbosch University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2421-1414","authenticated-orcid":false,"given":"Amanda S.","family":"Brand","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05bk57929","id-type":"ROR","asserted-by":"publisher"}],"name":"Stellenbosch University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9114-1452","authenticated-orcid":false,"given":"Celeste","family":"Naude","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05bk57929","id-type":"ROR","asserted-by":"publisher"}],"name":"Stellenbosch University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1161-4553","authenticated-orcid":false,"given":"Funeka","family":"Bango","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05q60vz69","id-type":"ROR","asserted-by":"publisher"}],"name":"South African Medical Research Council"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3501-8601","authenticated-orcid":false,"given":"Gerald","family":"Manthalu","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/004rh7a97","id-type":"ROR","asserted-by":"publisher"}],"name":"Public Health Institute of Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9035-9193","authenticated-orcid":false,"given":"Dachi","family":"Arikpo","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05qderh61","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Calabar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7115-9535","authenticated-orcid":false,"given":"Tamara","family":"Kredo","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05q60vz69","id-type":"ROR","asserted-by":"publisher"}],"name":"South African Medical Research Council"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2011-5844","authenticated-orcid":false,"given":"Lungiswa","family":"Nkonki","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05bk57929","id-type":"ROR","asserted-by":"publisher"}],"name":"Stellenbosch University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Safiri S, Kolahi AA, Noori M, et al. 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