BACKGROUND
Nutrition‐sensitive, overnutrition, stunting, malnutrition
CHILD MALNUTRITION, OVERNUTRITION, UNDERNUTRITION, UNDERNOURISHED, MALNUTRITION, WASTED
Child and maternal malnutrition is a persistent problem in Bangladesh. The prevalence of stunting in Bangladesh is 31% for children under 5, with 9% severely stunted and 2% severely wasted. Further, children in rural areas of the country are more likely to be stunted than their counterparts in urban areas. In Bangladesh, 24% of ever‐married women between the ages of 15−19 years of age are undernourished and rural women are more likely to suffer from undernourishment than urban women. At the same time, the proportion of overweight women has increased to 32%, highlighting the problem of both under and overnutrition in the country (NIPORT & ICF, Nutrition‐specific interventions that address the immediate causes of malnutrition have long been used to target undernutrition. Nutrition‐sensitive interventions—that address intermediate or underlying causes of malnutrition and address multiple outcomes—have also shown promise. Nutrition‐sensitive agriculture (NSA) programmes, in particular, have the potential to accelerate progress in addressing child malnutrition (Ruel & Alderman, The Targeting and Realigning Agriculture to Improve Nutrition (TRAIN) project was a multisectoral nutrition‐sensitive intervention implemented in rural Bangladesh by the nonprofit Building Resources Across Communities (BRAC). The intervention was designed to be evaluated by a randomised controlled trial (RCT). The RCT baseline survey was implemented in 2016−2017 by the International Food Policy Research Institute (IFPRI).This study presents the incremental costs of implementing an integrated agriculture‐nutrition intervention through an existing BRAC microcredit platform.Financial costs represent the implementing partner's actual expenditures on goods and services purchased to deploy the intervention. Economic costs, on the other hand, are defined as the opportunity cost of all of the resources used to produce something; and can include the value of resources that may not have been paid for, such as volunteer frontline worker time or programme participant time. Once data becomes available from an ongoing impact evaluation, these costs will be combined with programme benefits for a full economic evaluation including cost‐benefit and cost‐effectiveness analyses.Our findings serve many purposes. A robust understanding of the costs of multisectoral nutrition strategies is critical for priority‐setting and for motivating donors. This study is useful for governments and development partners to target investments in multisectoral nutrition programmes. Standardised unit cost data provides a cost benchmark for governments, donors and non‐profit organisations on how to design, budget and measure the resource requirements of interventions. Lastly, this analysis contributes to an effort to build an evidence base on the costs of multisectoral nutrition programmes across different settings and platforms. This study was conducted by the Strengthening Economic Evaluation for Multisectoral Strategies for Nutrition (SEEMS‐Nutrition) consortium, led by the University of Washington in partnership with IFPRI. SEEMS‐Nutrition develops standardised approaches and tools to assess the costs and benefits of multisectoral nutrition programmes.