Project: Maternal Health

To reduce the risk of complications during and following pregnancy, the World Health Organization (WHO) recommends elemental iron and folic acid supplements (IFAS) as part of antenatal care. However, anemia and subsequent birth complications continue to be an issue in developing countries. The International community has been exploring other interventions to target this issue, including Multiple micronutrient (MMS) supplements. The evidence collected to date however does not provide a final recommendation on the choice between IFA and MMS. As a result, the most recent WHO guidelines at the time of this project left the choice between IFA and MMS to countries, without providing any methodology or guidance on how to make this decision.

Limestone was hired by Nutrition International to develop a cost-effectiveness analysis model capable of helping countries choose between IFA and MMS. Limestone’s work resulted in a probabilistic analytical model to answer this question. The results of this work have so far been presented at the New York Academy of Sciences and the Society for Benefit-Cost Analysis. To effectively advise the client, Limestone conducted the following:

  • Situation analysis
  • Systematic review of existing evidence
  • Cost-effectiveness analysis
  • Probabilistic analysis using Monte-Carlo simulations
  • Development of a web-based dashboard
  • Writing an academic manuscript for publication

The analytical model has so far been used in the following contexts: Pakistan, Bangladesh, and India.

Clients / Partners

Timeline

June-July

2017

Research
  • Conducted comprehensive research regarding IFAS and MMS effectiveness and costs
  • Developed deterministic and probabilistic model to compare supplement modalities
  • Created visual model interface for clients future use in other contexts
  • Produced final report summarizing model outcomes and implications
August-Present

2017-2018

Model Development, Final Report, Visualizations
  • Developed deterministic and probabilistic model to compare supplement modalities
  • Created visual model interface for clients future use in other contexts
  • Produced final report summarizing model outcomes and implications
December-Present

2017-2018

Publication
  • Drafted a manuscript to be submitted for academic publication