Vol. 2 No. 1 (2025)

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Protocol for the Economic Evaluation of a Community-Based Management Model for Severe Acute Malnutrition Using Locally-Sourced Ready-to-Use Therapeutic Food in Niger (2021–2026)

Mariama Abdou, Abdou Moumouni University, Niamey Aïchatou Moussa, Abdou Moumouni University, Niamey Boubacar Diallo, National Institute of Agricultural Research of Niger (INRAN) Idrissa Hamani, National Institute of Agricultural Research of Niger (INRAN)
DOI: 10.5281/zenodo.18363989
Published: January 25, 2026

Abstract

This protocol details the planned economic evaluation of a community-based management (CBM) model for severe acute malnutrition (SAM) in Niger, which uses ready-to-use therapeutic food (RUTF) manufactured from locally-sourced ingredients. The study aims to determine the cost-effectiveness and budget impact of this localised model compared to the standard programme relying on imported RUTF, adopting both health system and societal perspectives. The evaluation will be conducted alongside a larger, non-inferiority cluster-randomised controlled trial implemented from 2021 to 2026 across four regions. A within-trial analysis will be complemented by a decision-analytic model to extrapolate longer-term health and economic outcomes. Primary data on resource use, costs, and clinical outcomes will be collected prospectively. Key outcome measures are the incremental cost per disability-adjusted life year (DALY) averted and the cost per child successfully treated. The analysis will adhere to the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. Given the high burden of SAM and the financial pressure of imported RUTF on health systems, this evaluation is crucial. Its findings will guide national and regional policy on scaling sustainable, nutrition-sensitive interventions. By rigorously assessing a model integrated with local agricultural value chains, this work supports goals of health sovereignty and resilient food systems, aiming to enhance programme sustainability and reduce costs.

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How to Cite

Mariama Abdou, Aïchatou Moussa, Boubacar Diallo, Idrissa Hamani (2026). Protocol for the Economic Evaluation of a Community-Based Management Model for Severe Acute Malnutrition Using Locally-Sourced Ready-to-Use Therapeutic Food in Niger (2021–2026). African Journal of Public Health and Health Systems, Vol. 2 No. 1 (2025), 15-33. https://doi.org/10.5281/zenodo.18363989

Keywords

Economic evaluationCommunity-based managementSevere acute malnutritionReady-to-use therapeutic foodSahel regionCost-effectiveness analysisFood sovereignty

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Vol. 2 No. 1 (2025)
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References

  • Adesoro, O., Oresanya, O., Counihan, H., Hamade, P., Eguavon, D., Emebo, C., Marron, B., Kozuki, N., Isah, A., Gimba, P., Isokpunwu, C.O., Maxwell, K., & Tibenderana, J. (2021). A Feasibility Study to Assess Non-clinical Community Health Workers’ Capacity to use Simplified Protocols and Tools to Treat Severe Acute Malnutrition in Niger State Nigeria. https://doi.org/10.21203/rs.3.rs-577712/v1
  • Bai, G., Parkash, A., Kumar, V., Das, K., Akhtar, U., & ., A. (2022). Effectiveness of Ready-to-Use Therapeutic Food Among Children With Protein-Calorie Malnutrition . Cureus. https://doi.org/10.7759/cureus.25872
  • Banda, T., Chawanda, K., Tsuchida, W., & Kathumba, S. (2021). Report of a Pilot Program Using a Milk-Free Ready-to-Use Therapeutic Food Made From Soya, Maize, and Sorghum to Treat Severe Acute Malnutrition. Food and Nutrition Bulletin. https://doi.org/10.1177/0379572120968703
  • Broadley, I., White, R., & Jaffee, A. (2022). Nutrition training for medical professionals: where do we begin?. British Journal of Cardiology. https://doi.org/10.5837/bjc.2022.028
  • Fetriyuna, F., Purwestri, R.C., Susandy, M., Köhler, R., Jati, I.R.A.P., Wirawan, N.N., & Biesalski, H. (2021). Composite Flour from Indonesian Local Food Resources to Develop Cereal/Tuber Nut/Bean-Based Ready-to-Use Supplementary Foods for Prevention and Rehabilitation of Moderate Acute Malnutrition in Children. Foods. https://doi.org/10.3390/foods10123013
  • Hadi, S., Amani, R., Tehrani, M.M., Hadi, V., Hejri, S., & Askari, G. (2022). Ready-to-Use Therapeutic Food (RUTF) Formulations with Functional Food and Nutrient Density for the Treatment of Malnutrition in Crisis. International Journal of Preventive Medicine. https://doi.org/10.4103/ijpvm.ijpvm_304_20
  • Kudhayer, N., & Habib, S. (2021). Ready to-Use Supplementary Food in the Outpatient Management of Children with Acute Malnutrition in Basrah. The Medical Journal of Basrah University. https://doi.org/10.33762/mjbu.2021.130966.1085
  • Kurniasih, H. (2022). THE INFLUENCE OF RUTF (READY TO USE THERAPEUTIC FOOD) ON WEIGHT GAINS IN POOR NUTRITIONAL TOLLS IN THE WORK AREA OF CIBALIUNG PUSKESMAS, PANDEGLANG REGENCY BANTEN 2021. JURNAL KEBIDANAN. https://doi.org/10.35890/jkdh.v11i1.195
  • Marzoog, A.S., Ali, B.M., & Ali, L.O. (2022). Ready to use therapeutic food (RUTF) for outpatient-based nutritional rehabilitation of severe acute malnutrition in children aged 6-59 months.. International journal of health sciences. https://doi.org/10.53730/ijhs.v6ns3.8440
  • Ogobara Dougnon, A., Charle-Cuéllar, P., Toure, F., Aziz Gado, A., Sanoussi, A., Lazoumar, R.H., Alain Tchamba, G., Vargas, A., & Lopez-Ejeda, N. (2021). Impact of Integration of Severe Acute Malnutrition Treatment in Primary Health Care Provided by Community Health Workers in Rural Niger. Nutrients. https://doi.org/10.3390/nu13114067
  • Okereke, (2021). Management of Produced Water from Niger Delta Oilfield with Modified Agricultural Waste. Petroleum and Chemical Industry International. https://doi.org/10.33140/pcii.04.01.01
  • Potani, I., Spiegel-Feld, C., Brixi, G., Bendabenda, J., Siegfried, N., Bandsma, R.H.J., Briend, A., & Daniel, A.I. (2021). Ready-to-Use Therapeutic Food (RUTF) Containing Low or No Dairy Compared to Standard RUTF for Children with Severe Acute Malnutrition: A Systematic Review and Meta-Analysis. Advances in Nutrition. https://doi.org/10.1093/advances/nmab027
  • Quak, E. (2021). Lessons Learned from Community-based Management of Acute Malnutrition (CMAM) Programmes that Operate in Fragile or Conflict Affected Settings. https://doi.org/10.19088/k4d.2021.133
  • Usman, B., Orushagbemi, C.O., & Safiya, A.T. (2022). Outcome Evaluation of Community Management of Severe Acute Malnutrition in Some Selected Outpatient Therapeutic Programme Centres of Katsina State, Nigeria. UMYU Scientifica. https://doi.org/10.56919/usci.1122.029
  • Wulandari, D., Yulianto, Y., & Terati, T. (2022). PEMBERIAN PRODUK READY TO USE THERAPEUTIC FOOD (RUTF) BERBAHAN TEPUNG IKAN LELE DAN KACANG HIJAU TERHADAP BERAT BADAN BALITA WASTING. Media Kesehatan Politeknik Kesehatan Makassar. https://doi.org/10.32382/medkes.v17i2.2917