Delaram Ghodsi is a nutritionist in Department of Community Nutrition at Faculty of Nutrition Sciences and Food Technology, SBMU, Tehran, Iran. Her areas of expertise are designing, planning and evaluation of the community-based nutritional program. She conducted the first comprehensive evaluation, including policy analysis, process and effect evaluation, and cost analysis, of one national nutritional program in Iran. She is working on development and implementation of nutrition strategies to improve children nutritional status, based on the results and challenges found in the evaluation study.


Statement of the Problem: Evidences support that using supplementary foods is good strategy for combating malnutrition in children. In Iran, in the supportive section of a national nutritional program for improvement of nutritional status of children under 6years, monthly food supplement is distributed targeting malnourished/growth retarded children. This study aimed to reports impacts and cost results from this food distribution program in two provinces: Semnan and Qazvin, Iran.

Methodology & Theoretical Orientation: Monthly implementation costs of the program, including food basket, staff, training and education material, travel, and capital, were calculated using accounting records and key informant interviews, in 2014. An activity-based costing (ABC) was applied to calculate monthly program implementation costs per child. To measure the effect of the program, 362 children under coverage of the program and 409 matched children under coverage of Primary Health Care (PHC) system were studies as intervention and control group, respectively. Weight and height of children in both groups were measured at the baseline of the study and 6 month thereafter.

Findings: Although there was improvement in nutritional status of children in both groups at the end of the study, there were not significant differences in anthropometric indices at the end of the study compared to the beginning between two groups (P>0.05). The implementation cost, was   31.5$ per child (the average exchange rate for 2013). About 58.5% of the total cost of the programs was accounted for food baskets. As a proportion of the overall costs, food baskets were the largest component, followed by capital.

Conclusion & Significance: Based on the results, food component is the highest portion of monthly implementation cost. The implementation cost of the program per child is partially low due to implementation of the program via PHC. This program could be more efficient if it was implemented properly by using PHC capacity.


Recent Publications

1. Ghodsi, D., Omidvar, N., Rashidian, A., Raghfar, H., Eini-Zinab, H., & Ebrahimi, M. (2016). Key Informants’ Perceptions on the Implementation of a National Program for Improving Nutritional Status of Children in Iran. Food and Nutrition Bulletin, 2017; 38(1):: 78-91


1.       Wilford R, Golden K, Walker DG. Cost-effectiveness of community-based management of acute malnutrition in Malawi. Health Policy and Planning. 2012;27(2):127-37.

2.       Tekeste A, Wondafrash M, Azene G, Deribe K. Cost effectiveness of community-based and in-patient therapeutic feeding programs to treat severe acute malnutrition in Ethiopia. Cost effectiveness and resource allocation : C/E. 2012;10:4.

3.       Purwestri RC, Scherbaum V, Inayati DA, Wirawan NN, Suryantan J, Bloem MA, et al. Cost analysis of community-based daily and weekly programs for treatment of moderate and mild wasting among children on Nias Island, Indonesia. Food and Nutrition Bulletin. 2012;33(3):207-16.

4.       Davis G, Serrano EL, McFerren M, Fournellier J, Baral R, Badirwang KF, et al. Cost-Effectiveness of Nutrition Education Programs for Limited-Resource Youth. Journal of Nutrition Education and Behavior. 2012;44(4, Supplement):S91-S2.

5.       Bachmann MO. Cost-effectiveness of community-based treatment of severe acute malnutrition in children. Expert Rev Pharmacoecon Outcomes Res. 2010;10(5):605-12.

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