Oral iron supplementation as a public health intervention in children aged 6 to 23 months for preventing iron deficiency and anaemia: Economic evaluation for the South African health system

African Journal of Primary Health Care & Family Medicine

 
 
Field Value
 
Title Oral iron supplementation as a public health intervention in children aged 6 to 23 months for preventing iron deficiency and anaemia: Economic evaluation for the South African health system
 
Creator Vorster, Pamela Brand, Amanda S. Naude, Celeste Bango, Funeka Manthalu, Gerald Arikpo, Dachi Kredo, Tamara Nkonki, Lungiswa
 
Subject Primary health care; child health cost-effectiveness analysis; iron supplementation; anaemia; prevention; child; guidelines; guideline adaptation.
Description Background: Anaemia prevalence among Southern African children aged 6–23 months was estimated at 65% in 2019. The World Health Organization recommends that children aged 6–23 months living in countries with an anaemia prevalence above 40% should receive preventive oral iron supplements.Aim: This study aimed to conduct a context-specific economic evaluation of oral iron supplementation in children aged 6 months – 23 months for preventing iron deficiency and anaemia in South Africa (SA).Method: We undertook a cost-effectiveness analysis (CEA), comparing preventive iron supplementation with no supplementation. Using a 1-year time horizon, we took a provider perspective and used circulating haemoglobin as the effectiveness outcome. The incremental cost-effectiveness ratio (ICER) was calculated as the cost per disability-adjusted life year (DALY) because of anaemia averted. A budget impact analysis (BIA) was carried out to estimate start-up and total annual costs of intervention implementation in SA.Results: The ICER (cost per DALY averted) was R1077.00 ($58.40); below a conservative context-relevant threshold (R62 916.00 [$3410.00]) (2024). Budget impact analysis estimated total costs over 2 years (2024–2025), excluding start-up costs, of R16.94 ($0.92) per child aged 2 years in SA, based on the CEA dosing regimen. Intervention costs (including start-up costs) represent 0.007% of the total health budget (2024).Conclusion: Preventive oral iron supplementation resulted in increased effectiveness for averting DALYs because of anaemia. Comparisons of the ICER with context-relevant thresholds suggested the intervention could be considered cost-effective in SA.Contribution: Our findings of potential cost-effectiveness and budget impact could be used to inform decision-making for primary healthcare resource allocation in SA’s health system.
 
Publisher AOSIS
 
Contributor EDCTP2 programme (grant number RIA2020S-3303-GELA) UK aid from the UK government (READ-It, project number 300342-104)
Date 2026-04-16
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Economic evaluation using clinical effects from a systematic review
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/phcfm.v18i1.5083
 
Source African Journal of Primary Health Care & Family Medicine; Vol 18, No 1 (2026); 11 pages 2071-2936 2071-2928
 
Language eng
 
Relation
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://phcfm.org/index.php/phcfm/article/view/5083/9227 https://phcfm.org/index.php/phcfm/article/view/5083/9228 https://phcfm.org/index.php/phcfm/article/view/5083/9229 https://phcfm.org/index.php/phcfm/article/view/5083/9230
 
Coverage South Africa 2023-2025 Infants and young children aged 6-23 months
Rights Copyright (c) 2026 Pamela Vorster, Amanda S. Brand, Celeste Naude, Funeka Bango, Gerald Manthalu, Dachi Arikpo, Tamara Kredo, Lungiswa Nkonki https://creativecommons.org/licenses/by/4.0
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