Publications by authors named "Jules G Assiene"

Designing a cost-effective portfolio of micronutrient intervention programs is complex and generally undertaken with limited data. We developed the MINIMOD-Secondary Data (MINIMOD-SD) tool, which uses household consumption and expenditure survey data and other secondary data to estimate apparent nutrient intakes and model the effectiveness and cost-effectiveness of micronutrient intervention programs. We present the SD tool methodology and results in the context of Cameroon, with a particular focus on vitamin A (VA) for children and folate for women of reproductive age (WRA).

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Background: Policy makers aiming to reduce micronutrient deficiencies (MNDs) and their health effects must choose among alternative definitions of impact when evaluating cost-effectiveness.

Objective: Estimate the cost-effectiveness of a mandatory wheat flour fortification program for reducing cases of MNDs (iron, zinc, folate, vitamin B12), anemia and neural tube defects (NTDs) averted, and disability-adjusted life years (DALYs) averted in urban Cameroon.

Methods: A 13-year predictive model was developed, including a 3-year start-up period and 10 years of program activity.

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Meeting children's vitamin A (VA) needs remains a policy priority. Doing so efficiently is a fiscal imperative and protecting at-risk children during policy transitions is a moral imperative. Using the Micronutrient Intervention Modeling tool and data for Cameroon, we predict the impacts and costs of alternative VA intervention programs, identify the least-cost strategy for meeting targets nationally, and compare it to a business-as-usual (BAU) strategy over 10 years.

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Article Synopsis
  • Cameroon has mandated the fortification of vegetable oil with vitamin A and wheat flour with various micronutrients since 2011, but initial levels of fortification have not met the targets, particularly for oil.
  • A study used a program impact pathway to analyze barriers to effective food fortification, conducting interviews with factories and assessing food availability and consumption among households.
  • Results showed that while some factories maintained quality standards, actual micronutrient levels in fortified foods were often well below targets, indicating room for improvement in the program's effectiveness.
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