scholarly journals Determinants of the Global Prices of Ready-to-Use Therapeutic Foods

2018 ◽  
Vol 39 (3) ◽  
pp. 435-448 ◽  
Author(s):  
Jakub Kakietek
Keyword(s):  
Price Competition ◽  
Severe Acute Malnutrition ◽  
Estimating Equation ◽  
Cost Driver ◽  
Acute Malnutrition ◽  
Generalized Estimating Equation ◽  
Market Fragmentation ◽  
Outpatient Settings ◽  
The Impact ◽  
Therapeutic Food

Background: A therapy based on ready-to-use therapeutic food (RUTF) in outpatient settings is considered the gold standard in the treatment of severe acute malnutrition in children younger than 5 years. The price of RUTF is the key cost driver of the therapy. However, no studies to date have systematically examined the determinants of RUTF prices. Objective: This article presents the first analysis of factors associated with the prices of RUTF, focusing on the impact of competition and tendering. Methods: This article examines data on the prices of RUTF purchased by UNICEF Supply Division from 2006 through 2015 (90% of RUTF purchased globally). To assess the association between price, competition, and tender introduction, controlling for potential confounding factors, regression analysis using a generalized estimating equation was used. Results: Competition, measured as the number of suppliers, was negatively associated with RUTF price. On the other hand, no statistically significant association was found between RUTF price tendering. Quantities sold were also significantly associated with RUTF prices. Conclusions: Significant price reductions have been achieved by increasing competition in the RUTF market. In contrast, introduction of tendering did not result in decreases in prices. Tendering is an effective price-lowering mechanism because it awards the bidder(s) with the lowest price with market exclusivity. However, the current tender system promotes market fragmentation and reduces the incentives for price reductions. Further reduction in RUTF prices can likely be achieved by modifying the current tendering procedures and putting a greater emphasis on price competition.

Treatment of severe acute malnutrition with oat or standard ready-to-use therapeutic food: a triple-blind, randomised controlled clinical trial

Gut ◽  
2020 ◽  
Vol 69 (12) ◽  
pp. 2143-2149 ◽  
Author(s):  
David Taylor Hendrixson ◽  
Claire Godbout ◽  
Alyssa Los ◽  
Meghan Callaghan-Gillespie ◽  
Melody Mui ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Vegetable Oil ◽  
Severe Acute Malnutrition ◽  
Milk Powder ◽  
Acute Malnutrition ◽  
Growth Time ◽  
Controlled Clinical Trial ◽  
Hydrogenated Vegetable Oil ◽  
Therapeutic Food ◽  
Time To Graduation

ObjectiveWe hypothesised that an alternative RUTF (ready-to-use therapeutic food) made with oats (oat-RUTF) would be non-inferior to standard RUTF (s-RUTF).DesignThis was a randomised, triple-blind, controlled, clinical non-inferiority trial comparing oat-RUTF to s-RUTF in rural Sierra Leone. Children aged 6–59 months with severe acute malnutrition (SAM) were randomised to oat-RUTF or s-RUTF. s-RUTF was composed of milk powder, sugar, peanut paste and vegetable oil, with a hydrogenated vegetable oil additive. Oat-RUTF contained oats and no hydrogenated vegetable oil additives. The primary outcome was graduation, an increase in anthropometric measurements such that the child was not acutely malnourished. Secondary outcomes were rates of growth, time to graduation and presence of adverse events. Intention to treat analyses was used.ResultsOf the 1406 children were enrolled, graduation was attained in 404/721 (56%) children receiving oat-RUTF and 311/685 (45%) receiving s-RUTF (difference 10.6%, 95% CI 5.4% to 15.8%). Death, hospitalisation or remaining with SAM was seen in 87/721 (12%) receiving oat-RUTF and in 125/685 (18%) receiving s-RUTF (difference 6.2%, 95% CI 2.3 to 10.0, p=0.001). Time to graduation was less for children receiving oat RUTF; 3.9±1.8 versus 4.5±1.8 visits, respectively (p<0.001). Rates of weight in the oat-RUTF group were greater than in the s-RUTF group; 3.4±2.7 versus 2.5±2.3 g/kg/d, p<0.001.ConclusionOat-RUTF is superior to s-RUTF in the treatment of SAM in Sierra Leone. We speculate that might be because of beneficial bioactive components or the absence of hydrogenated vegetable oil in oat-RUTF.Trial registration numberNCT03407326.

Indigenously Prepared Ready-to-use Therapeutic Food (RUTF) in Children with Severe Acute Malnutrition

2019 ◽  
Vol 56 (4) ◽  
pp. 287-293
Author(s):  
Alka Rajendra Jadhav ◽  
Prachi Karnik ◽  
Lavina Fernandes ◽  
Sneha Fernandes ◽  
Narendra Shah ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Therapeutic Food

scholarly journals Optimal design for a psychosocial intervention on severely acute malnourished children in humanitarian settings: results of an expert survey

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 1073
Author(s):  
Dieynaba S N'DIAYE ◽  
Cécile Salpéteur ◽  
Cécile Bizouerne ◽  
Karine Le Roch
Keyword(s):  
Optimal Design ◽  
Online Survey ◽  
Psychosocial Support ◽  
Severe Acute Malnutrition ◽  
Psychosocial Interventions ◽  
Acute Malnutrition ◽  
Design Stage ◽  
Humanitarian Settings ◽  
The Impact ◽  
Combined Intervention

Background: Common psychosocial interventions focus on feeding, stimulation, emotional responsiveness and childcare and parenting. Inclusion of such a component in the outpatient management of severe acute malnutrition (SAM) children is recommended. However, clinical assessment of such interventions is tedious in humanitarian settings and modalities evidence on the impact of psychosocial interventions alongside nutrition protocol for SAM is scarce.  This survey aimed to gather expert opinions on the optimal design of a combined psychosocial and nutrition intervention feasible in humanitarian settings. Methods: From March to May 2018, an online survey was emailed to international experts in nutrition and mental health and psychosocial support, mainly from academia and international non-governmental organisations (INGOs). It included multiple choices questions on the key components of an optimal combined intervention. Results: Of the 76 experts targeted, 20 responded. 11 (55%) belonged to INGOs, 2 (10%) to academia, and 4 (20%) to international organizations and donors. For most respondents, a combined intervention should be provided in weekly 45-minuites counselling sessions, provided individually (rather than in a group) and at home (rather than at a health center). None of the proposed ideal duration (two, four or six months) gained the majority of votes. Experts thought that 35% staff training should be in “Active listening for psychosocial support”, and 30% in “Early child development”, 25% in “Maternal depression” and 9% in “Anthropometric measurements”. They estimated that a combined intervention could improve SAM recovery rate by 10% (min-max: 0-19%) vs. the nutritional protocol alone. Qualitative results highlighted the importance of tailoring the intervention to the individual, the population and the settings; as well as considering feasibility and scalability at the design stage. Conclusion: These findings could guide further research on the impact of psychosocial interventions on SAM children’s health and development, and help designing innovative approaches to treat undernutrition.

scholarly journals Effectiveness of Ready-to-Use Therapeutic Food in Improving the Developmental Potential and Weight of Children Aged under Five with Severe Acute Malnourishment in Pakistan: A Pretest-Posttest Study

2021 ◽  
Vol 18 (17) ◽  
pp. 9060
Author(s):  
Javeria Saleem ◽  
Rubeena Zakar ◽  
Gul Mehar Javaid Bukhari ◽  
Mahwish Naz ◽  
Faisal Mushtaq ◽  
...  
Keyword(s):  
Weight Gain ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
World Health ◽  
Fine Motor ◽  
Strong Positive Correlation ◽  
Developmental Potential ◽  
Under Five ◽  
Baseline Weight ◽  
Therapeutic Food

The objective of this study was to assess whether the standard therapy of ready-to-use therapeutic food in the treatment of uncomplicated severe acute malnutrition (SAM) is effective in improving developmental potential and weight gain in children aged under five years. A multicenter pretest-posttest study was conducted among 91 children aged under five with uncomplicated SAM in Pakistan. Study participants completed their eight weeks’ therapy of ready-to-use therapeutic food according to the World Health Organization’s (WHO) standard guidelines. The study outcome was the proportion of children with improved developmental potential in all domains in comparison with the pretreatment status and children gaining >15% of their baseline weight; mean weight-for-height/length z-score after completing eight weeks’ therapy of ready-to-use therapeutic food. The Denver Development Screening Tool II was used for developmental screening. Significant changes (p < 0.05) were observed for developmental status milestones in terms of gross motor, fine motor, and personal/social milestones, as well as language and global development milestones. There was a strong positive correlation (r = 0.961) between initial weight and weight at the last visit (p < 0.001). Ready-to-use therapeutic food is effective in improving development potential as well as promoting weight gain in children aged under five with uncomplicated SAM if provided according to WHO guidelines.

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