Meera Shekar IFPRI-FAO conference side event, "Accelerating the End of Hunger and Malnutrition" November 28–30, 2018 Bangkok, Thailand

1. A Tool for Enhancing the Efficiency of Nutrition Spending
Side Event: Nov 28, 2018: 1630-1800
Room: President 1&2
Intercontinental Bangkok
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2. Optima Nutrition …..
….Within the wider ecosystem of advanced analytics brought
on by the advent of big data and advanced analytics
….Within the architecture of a global movement from cost
effectiveness analyses in health to the use of
mathematical models to improve decision making
…. Within the context of other decision science tools in
health

3. LiST
One Health
PROFILES
Single intervention
FANTA
CMAM
MINIMOD
WBCi
Existing Nutrition tools for impact & economic analyses
Multiple interventions
Investment
Coverage
Health
impact
Economic
impact
Optimizatio
n
Budget
impact
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4. What is Optima Nutrition?
• Mathematical model and a decision support tool
• Focuses on child and maternal nutrition: stunting, wasting, anemia
• Core interventions are nutrition-specific, albeit some nutrition-
sensitive interventions added on
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• Part of a larger effort and a
suite of products for
allocative efficiency analysis
in different areas of health
• Collaboration between the
Bill and Melinda Gates
Foundation, the Burnett
Institute, and the World
Bank

5. $
Overall budget
available for nutrition
Which combination of investments leads to maximum impacts?
Balanced energy
protein
supplementation
Infant and young
child feeding
education
Vitamin A
supplements
Iron and folic acid
supplementation
Treatment of
SAM
Prophylactic
Zinc
supplements
IPTp
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Key question: how should a budget be allocated across
different nutrition interventions to maximize impacts?

6. Linking Investments with Impacts
• Combines information on cost, coverage, and impact of
interventions
• Identifies the best/highest impact allocations of resources
across different interventions and/or…
$
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7. Questions addressed by Optima Nutrition
• For different funding levels, how should resources be allocated
across a mix of nutrition interventions and what impact is
achievable?
• Optimal outcomes can be measured as:
• minimised stunting cases
• minimised stunting prevalence
• minimised wasting prevalence
• minimised anaemia prevalence
• minimised deaths or
• A combination of the above, e.g. maximising the number of
alive non-stunted children (“alive and thrive”).
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8. Applications to Date, and Next Steps
• Initial test applications using Tanzania and
Bangladesh data
• Optimization across different interventions
• Optimization across different regions
• Optima Nutrition studies launched in DRC, Tajikistan
and Burundi
• Further requests received for country-level analyses
from Myanmar, Indonesia, Benin, Togo, Bangladesh,
Rwanda, Pakistan, Zimbabwe, Sierra Leone, Burkina
Faso
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9. Capacity Building for Optima Nutrition to Date
• Three regional trainings in 2018:
• Bucharest, Bangkok, Pretoria
• 52 staff from national health and nutrition programs trained from 15
countries (Bangladesh, Benin, Burkina Faso, Djibouti, India,
Madagascar, Myanmar, Nepal, Pakistan, Sierra Leone, Tajikistan,
Tanzania, Ukraine, Zambia, Zimbabwe)
• 28 additional participants from development organizations (BMGF,
DFID, FAO, Power of Nutrition, USAID, WFP and World Bank) and
academic institutions (University of California Davis, University of
Pretoria, Johns Hopkins University, the Sackler Institute)
• Overwhelmingly positive feedback; interest in country-level trainings
in: India, Nigeria
• Bellagio consultation: Nov 2018: 20 participants form countries,
development partners
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10. Tanzania Application: Linking Investments with Impacts
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$0
$10
$20
$30
$40
$50
$60
$70
Estimated
2016
spending
Estimated NMNAP
planned spending
Optimised
spending
Spendingoninterventions(millionUS$)
National optimisation results
(Tanzania Example)
To maximise the number of alive and non-stunted children 2017-2030
Vitamin A supplementation
Public provision of complementary
foods
IYCF
Balanced energy-protein
supplementation
Multiple micronutrient
supplementation

11. Linking Investments with Impacts: Tanzania
• … the best/highest
impact allocations
across different
geographies (regions,
provinces)
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12. Bangladesh Application: Optimal allocation of additional
resources across regions
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0
2
4
6
8
10
12
$m
Dhaka
Optima
l
2014
spend
0
2
4
6
8
10
12
$m
Barisal
0
2
4
6
8
10
12
$m
Chittagong
0
2
4
6
8
10
12
$m
Khulna
0
2
4
6
8
10
12
$m
Rajshahi
0
2
4
6
8
10
12
$m
Rangpur
0
2
4
6
8
10
12
$m
Sylhet
0
25
50
75
100
100%
150%
200%
300%
400%
Spending(millionUSD)
Breastfeeding promotion
Public provision of
complementary foods
Balanced energy-protein
supplementation
Vitamin A supplementation
Complementary feeding
education
Antenatal micronutrient
supplementation
Estimated
spending
Optimized spending
2014 budget
• Prioritizing
regions for
allocation of
additional
resources could
yield greatest
impact
• With additional
$10m,
prioritizing
scale-up in
Dhaka and
Chittagong
divisions achieve
greatest
reductions in
stunting

13. Thank You!
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