scholarly journals Forecasting the Value for Money of Mobile Maternal Health Information Messages on Improving Utilization of Maternal and Child Health Services in Gauteng, South Africa: Cost-Effectiveness Analysis (Preprint)

2017 ◽  
Author(s):  
Amnesty LeFevre ◽  
Maria A Cabrera-Escobar ◽  
Diwakar Mohan ◽  
Jaran Eriksen ◽  
Debbie Rogers ◽  
...  
Keyword(s):  
Maternal Health ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Cost Effective ◽  
Scaling Up ◽  
Text Messages ◽  
Value For Money ◽  
Gauteng Province ◽  
Childhood Immunizations ◽  
Program Costs

BACKGROUND Limited evidence exists on the value for money of mHealth information programs in low resource settings. OBJECTIVE This study sought to model the incremental cost-effectiveness of gradually scaling up text messaging services to pregnant women throughout Gauteng province, South Africa from 2012 to 2017. METHODS Data collection occurred as part of a retrospective study in 6 health centers in Gauteng province. Stage-based short message service (SMS) text messages on maternal health were sent to pregnant women twice per week during pregnancy and continued until the infant’s first birthday. Program costs, incremental costs to users, and the health system costs for these women were measured along with changes in the utilization of antenatal care visits and childhood immunizations and compared with those from a control group of pregnant women who received no SMS text messages. Incremental changes in utilization were entered into the Lives Saved Tool and used to forecast lives saved and disability adjusted life years (DALYs) averted by scaling up program activities over 5 years to reach 60% of pregnant women across Gauteng province. Uncertainty was characterized using one-way and probabilistic uncertainty analyses. RESULTS Five-year program costs were estimated to be US $1.2 million, 17% of which were incurred by costs on program development and 31% on SMS text message delivery costs. Costs to users were US $1.66 to attend clinic-based services, nearly 90% of which was attributed to wages lost. Costs to the health system included provider time costs to register users (US $0.08) and to provide antenatal care (US $4.36) and postnatal care (US $3.08) services. Incremental costs per DALY averted from a societal perspective ranged from US $1985 in the first year of implementation to US $200 in the 5th year. At a willingness-to-pay threshold of US $2000, the project had a 40% probability of being cost-effective in year 1 versus 100% in all years thereafter. CONCLUSIONS Study findings suggest that delivering SMS text messages on maternal health information to pregnant and postpartum women may be a cost-effective strategy for bolstering antenatal care and childhood immunizations, even at very small margins of coverage increases. Primary data obtained prospectively as part of more rigorous study designs are needed to validate modeled results.

scholarly journals Promoting Antenatal Care Attendance Through a Text Messaging Intervention in Samoa: Quasi-Experimental Study

10.2196/15890 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e15890
Author(s):  
Jessica L Watterson ◽  
Diego Castaneda ◽  
Caricia Catalani
Keyword(s):  
Data Analysis ◽  
Maternal Health ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Text Messaging ◽  
Individual Characteristics ◽  
Text Messages ◽  
Quasi Experimental ◽  
Text Messaging Intervention ◽  
Sms Text Messaging

Background Antenatal care (ANC) has the potential to improve maternal health, but it remains underutilized and unevenly implemented in many low- and middle-income countries. Increasingly, text messaging programs for pregnant women show evidence that they can improve the utilization of ANC during pregnancy; however, gaps remain regarding how implementation affects outcomes. Objective This study aimed to assess facilitators and barriers to implementation of an SMS text messaging intervention for pregnant women in Samoa and to assess its impact on ANC attendance. Methods This study took place in Upolu, Samoa, from March to August 2014 and employed a quasi-experimental design. Half (n=3) of the public antenatal clinics on the island offered adult pregnant women the SMS text messaging intervention, with 552 women registering for the messages. At the comparison clinics (n=3), 255 women registered and received usual care. The intervention consisted of unidirectional text messages containing health tips and appointment reminders. The outcome of interest was the number of attended antenatal visits. Implementation data were also collected through a survey of the participating midwives (n=7) and implementation notes. Data analysis included a comparison of women’s baseline characteristics between the two groups, followed by the use of negative binomial regressions to test for associations between participation in the intervention and increased ANC attendance, controlling for individual characteristics and accounting for the clustering of women within clinics. Results The comparison of ANC attendance rates found that women receiving the SMS text messaging intervention attended 15% fewer ANC visits than the comparison group (P=.004), controlling for individual characteristics and clustering. Data analysis of the implementation process suggests that barriers to successful implementation include women registering very late in pregnancy, sharing their phone with others, and inconsistent explanation of the intervention to women. Conclusions These results suggest that unidirectional text messages do not encourage, and might even discourage, ANC attendance in Samoa. Interpreted with other evidence in the literature, these results suggest that SMS text messaging interventions are more effective when they facilitate better communication between patients and health workers. This study is an important contribution to our understanding of when SMS text messaging interventions are and are not effective in improving maternal health care utilization.

scholarly journals Promoting Antenatal Care Attendance Through a Text Messaging Intervention in Samoa: Quasi-Experimental Study (Preprint)

2019 ◽  
Author(s):  
Jessica L Watterson ◽  
Diego Castaneda ◽  
Caricia Catalani
Keyword(s):  
Data Analysis ◽  
Maternal Health ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Text Messaging ◽  
Individual Characteristics ◽  
Text Messages ◽  
Quasi Experimental ◽  
Text Messaging Intervention ◽  
Sms Text Messaging

BACKGROUND Antenatal care (ANC) has the potential to improve maternal health, but it remains underutilized and unevenly implemented in many low- and middle-income countries. Increasingly, text messaging programs for pregnant women show evidence that they can improve the utilization of ANC during pregnancy; however, gaps remain regarding how implementation affects outcomes. OBJECTIVE This study aimed to assess facilitators and barriers to implementation of an SMS text messaging intervention for pregnant women in Samoa and to assess its impact on ANC attendance. METHODS This study took place in Upolu, Samoa, from March to August 2014 and employed a quasi-experimental design. Half (n=3) of the public antenatal clinics on the island offered adult pregnant women the SMS text messaging intervention, with 552 women registering for the messages. At the comparison clinics (n=3), 255 women registered and received usual care. The intervention consisted of unidirectional text messages containing health tips and appointment reminders. The outcome of interest was the number of attended antenatal visits. Implementation data were also collected through a survey of the participating midwives (n=7) and implementation notes. Data analysis included a comparison of women’s baseline characteristics between the two groups, followed by the use of negative binomial regressions to test for associations between participation in the intervention and increased ANC attendance, controlling for individual characteristics and accounting for the clustering of women within clinics. RESULTS The comparison of ANC attendance rates found that women receiving the SMS text messaging intervention attended 15% fewer ANC visits than the comparison group (<i>P</i>=.004), controlling for individual characteristics and clustering. Data analysis of the implementation process suggests that barriers to successful implementation include women registering very late in pregnancy, sharing their phone with others, and inconsistent explanation of the intervention to women. CONCLUSIONS These results suggest that unidirectional text messages do not encourage, and might even discourage, ANC attendance in Samoa. Interpreted with other evidence in the literature, these results suggest that SMS text messaging interventions are more effective when they facilitate better communication between patients and health workers. This study is an important contribution to our understanding of when SMS text messaging interventions are and are not effective in improving maternal health care utilization.

scholarly journals Exploring COVID-19 Related Factors Influencing Antenatal Care Services Uptake: A Qualitative Study among Women in a Rural Community in Southwest Ethiopia

2021 ◽  
Vol 12 ◽  
pp. 215013272199689
Author(s):  
Shewangizaw Hailemariam ◽  
Wubetu Agegnehu ◽  
Misganaw Derese
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Qualitative Study ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Health Facility ◽  
Care Service ◽  
Maternal Health Service ◽  
Related Factors ◽  
Factors Influencing

Introduction: Evidences suggest a significant decline in maternal health service uptake following the coronavirus disease 2019 (COVID-19) pandemic in Ethiopia. However, COVID-19 related factors impacting the service uptake are not sufficiently addressed. Hence, the current study was intended to explore COVID-19 related factors influencing antenatal care service uptake in rural Ethiopia. Methods: A community-based qualitative study was conducted from September 25/2020 to November 25/2020 among selected pregnant women residing in rural districts of Bench-Sheko Zone, and healthcare providers working in the local health care facilities. Six focus group discussions and 9 in-depth interviews were made between pregnant women, and health care providers, respectively. Data was collected by health education and behavioral science professionals who also have experience in qualitative data collection procedure. Data were transcribed, translated, and analyzed thematically using Open Code 4.0 software. Result: The study revealed several COVID-19 related factors influencing the uptake of antenatal care service during the pandemic. Health facility related barriers, perceived poor quality of care during the pandemic, government measures against COVID-19, anxiety related to the pandemic, and risk minimization were the identified factors possibly influencing the current antenatal care service uptake among women in rural Bench-Sheko Zone. Conclusion: COVID-19 preventive measures, and health facility related factors and individual factors were responsible for the current decline in antenatal care service uptake. Preserving essential health care service is critical to prevent avoidable losses of maternal and child lives during the pandemic period. Hence, programs and strategies designed to maintain maternal health services particularly, antenatal care service have better take the above determinants into consideration.

scholarly journals A study on demographic and obstetric profile, its relation with present antenatal practices and prevalence of anaemia in pregnant women attending tertiary care hospital

2021 ◽  
Vol 8 (5) ◽  
pp. 2233
Author(s):  
Nitin A. Lodha
Keyword(s):  
Maternal Health ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Maternal Health Services ◽  
Study Data ◽  
Care Hospital ◽  
Chi Square ◽  
Cross Sectional

Background: Antenatal care is the care of a woman during pregnancy. The primary aim of antenatal care is to achieve at the end of pregnancy a healthy mother and a healthy baby. To improve maternal health, barriers which limit access to quality maternal health services must be identified and addressed at all levels of health system. Objectives were to determine demographic and obstetric factors affecting utilization of ANC service and prevalence of anaemia among pregnant women.Methods: This is cross-sectional descriptive study carried out in tertiary care hospital, using structured questionnaire, interviews were conducted with married pregnant women age between 18-45 years, who visited ANC clinic. Total 170 pregnant women visited hospital during a period was included in study. Data was analysed using MS excel and Epi info. Chi –square test was applied.Results: Maximum number of study subjects (42.9%) from age 23-27 years. 66.5% were Hindu, 56.5% study subjects from joint family. 14.7% were illiterate. 45.3% were primigravida, 54.7% were multigravida. 71.1% study subjects were from third trimester of pregnancy. 94.7% were taken at least one dose of Tetanus Toxoids. Iron folic acid tablets were taken by 87.6%. Prevalence of anaemia was 55.8%.Conclusions: Majority of pregnant women came for antenatal check-up, but regularity was not seen in most of cases. The presence study has brought out no significant socio-cultural barrier like women’s literacy, socio economic class and parity of women affecting the utilization of services.

scholarly journals Perceptions of pregnant woman on monetary and time sacrifice for satisfaction based on health workers roles in antenatal services to reduce the risk of maternal death at Gowa district

2019 ◽  
Vol 10 (2) ◽  
pp. 111-118
Author(s):  
Serawati Dewi ◽  
Yuni Romalita ◽  
Yusriani Yusriani ◽  
Muhammad Khidri Alwi
Keyword(s):  
Maternal Health ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Study Design ◽  
Health Workers ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

Latar belakang: Angka Kematian Ibu (AKI) merupakan salah satu indikator pembangunan kesehatan di Indonesia. Upaya percepatan penurunan AKI dapat dilakukan dengan menjamin agar setiap ibu mampu mengakses pelayanan kesehatan ibu hamil yang berkualitas. Apabila antenatal care dimanfaatkan dengan baik maka kesehatan ibu dapat terpantau secara berkesinambungan dari masa kehamilan sampai dengan persalinan. Metode: Desain penelitian adalah kuantitatif dengan rancangan cross sectional study. Populasi pada penelitian ini adalah semua ibu yang memiliki bayi usia 0-11 bulan di Kabupaten Gowa sebanyak 122 orang. Sampel sebanyak 93 orang diambil dengan menggunakan teknik accidental sampling, besar sampel ditentukan dengan menggunakan rumus Slovin Hasil: Persepsi ibu hamil terhadap peran petugas kesehatan dalam pelayanan antenatal berdasarkan pengorbanan moneter tidak menunjukkan korelasi. Ibu hamil yang memiliki persepsi pengorbanan moneter kecil dan mengatakan peran petugas kesehatan kurang dalam pelayanan antenatal sebanyak 90,0%. Ibu hamil yang memiliki persepsi pengorbanan moneter sangat kecil dan mengatakan peran petugas kesehatan kurang sebanyak 83.1%. Sedangkan persepsi pengorbanan waktu menunjukkan adanya korelasi dengan peran petugas kesehatan dalam pelayanan antenatal. Ibu hamil yang memiliki persepsi pengorbanan waktu besar dan mengatakan peran petugas kesehatan kurang dalam pelayanan antenatal sebanyak 100%. Ibu hamil yang memiliki persepsi pengorbanan moneter besar dan mengatakan peran petugas kesehatan kurang dalam pelayanan antenatal sebanyak 90.2%. Kesimpulan: Persepsi ibu hamil terhadap peran petugas kesehatan dalam pelayanan antenatal berdasarkan pengorbanan moneter tidak menunjukkan korelasi sedangkan berdasarkan pengorbanan waktu menunjukkan ada korelasi. Perlu meningkatkan kecepatan proses pelayanan pemeriksaan kehamilan pada ibu hamil oleh tenaga kesehatan. Kata kunci: Pelayanan antenatal, Ibu Hamil, Pengorbanan, Waktu, Moneter   Abstract Background: Maternal Mortality Rate (MMR) is one indicator of health development in Indonesia. Efforts to accelerate the reduction of MMR can be done by ensuring that every mother is able to access quality maternal health services. If antenatal care is utilized properly, maternal health can be monitored continuously from pregnancy to delivery. Methods: The study design was quantitative with a cross sectional study design. The population in this study were all pregnant women who had a gestational age of 7 to 9 months in Gowa Regency as many as 122 people. A sample of 93 people was taken using accidental sampling technique, the sample size was determined using the Slovin formula. Results: Perception of pregnant women towards the role of health workers in antenatal care based on monetary sacrifice did not show a correlation. Pregnant women who have a perception of small monetary sacrifice and say the role of health workers is lacking in antenatal care are 90.0%. Pregnant women who have a perception of monetary sacrifice are very small and say the role of health workers is less as much as 83.1%. While the perception of sacrifice of time shows a correlation with the role of health workers in antenatal care. Pregnant women who have the perception of sacrifice of big time and say the role of health workers lacking in antenatal care as much as 100%. Pregnant women who have a perception of great monetary sacrifice and say the role of health workers is lacking in antenatal care are 90.2%. Conclusion: Perception of pregnant women towards the role of health workers in antenatal care based on monetary sacrifice does not show correlation while based on time sacrifice shows there is correlation. Need to increase the speed of the process of pregnancy examination services for pregnant women by health workers. Keywords: Antenatal care, Pregnant Women, Sacrifice, Time, Monetary

Artificial Intelligence guided citizen-centric approach to enhance uptake of maternal health services among pregnant women living in urban slum settings in India. (Preprint)

2021 ◽  
Author(s):  
Rahul Shrivastava ◽  
Manmohan Singhal ◽  
Mansi Gupta ◽  
Ashish Joshi
Keyword(s):  
Artificial Intelligence ◽  
Decision Support ◽  
Maternal Health ◽  
Health Services ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Resource Planning ◽  
Urban Slum ◽  
Maternal Health Services ◽  
Urban Slums

BACKGROUND Pregnant women are considered to be a “high risk” group with limited access to health facilities in urban slums. Barriers to utilization of health services may lead to maternal and child mortality, morbidity, low birth weight, and children with stunted growth. Application of artificial intelligence (AI) can provide substantial improvements in all areas of healthcare from diagnostics to treatment. There have been several technological advances within the field of AI, however, AI not merely driven by what is technically feasible, but by what is humanly desirable is the need of the hour. OBJECTIVE The objective of our study is to develop and evaluate the AI guided citizen centric platform to enhance the uptake of maternal health services (antenatal care) amongst the pregnant women living in urban slum settings. METHODS A cross-sectional mixed method approach employed to collect data among pregnant women, aged 18-44 years, living in urban slums of South Delhi. A convenience sampling used to recruit 225 participants at the Anganwadi centres (AWC) after obtaining consent from the eligible participants. Inclusion criteria includes pregnant individuals residing in urban slums for more than 3 months, having smartphones, visiting AWC for seeking antenatal care. Quantitative and qualitative data will be collected electronically using Open Data Kit (ODK) based opensource tool from eligible participants. Data will be collected on clinical as well as socio-demographic parameters (based on existing literature). We aim to develop an innovative AI guided citizen centric decision support platform to effectively manage pregnancy and its outcomes among urban poor populations. The proposed research will help policymakers to prioritize resource planning, resource allocation and development of programs and policies to enhance maternal health outcomes. RESULTS The AI guided citizen centric decision support platform will be designed, developed, implemented and evaluated using principles of human centred design and findings of the study will be reported to diverse stakeholders. The tested and revised platform will be deployed for use across various stakeholders such as pregnant women, healthcare professionals, frontline workers, and policymakers. CONCLUSIONS With the understanding, use and adoption of emerging and innovative technologies such as AI, maternal health informatics can be at the forefront to help pregnant women in crisis. The proposed platform will potentially be scaled up to different geographic locations for adoption for similar and other health conditions.

scholarly journals A study on knowledge, attitude and practices regarding antenatal care among pregnant women attending antenatal clinic at a tertiary care hospital

2021 ◽  
Vol 10 (4) ◽  
pp. 1621
Author(s):  
Rajvir Kaur ◽  
Poonam Taneja ◽  
Isha Nandal
Keyword(s):  
Maternal Health ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Antenatal Clinic ◽  
Infant Mortality Rate ◽  
Safe Motherhood ◽  
Care Hospital

Background: The maternal health level of Indian women was noticed to be inferior as compared to other developed countries. Antenatal care is the clinical assessment of both mother and foetus, during the period of pregnancy. Safe motherhood by providing good antenatal care (ANC) is very crucial to reduce maternal mortality ratio and infant mortality rate and to achieve millennium development goals. The objectives of this study aimed to assess the level of knowledge, attitude, and practice on ANC among pregnant women attending the antenatal clinic and their association with several sociodemographic factors.Methods: A cross-sectional study was undertaken among 200 pregnant women in their 3rd trimester attending the OPD in a Tertiary Care Hospital of Gurugram, Haryana. Predesigned questionnaire was used for collecting data by interview after obtaining informed consent.Results: This study revealed that about 55% women had adequate knowledge regarding ANC. It was found that almost all the variables such as age, parity, level of education, occupation and type of family had a significant association with awareness about ANC. 90% women were having a positive attitude towards ANC. Around 70%, women were practicing this adequately.Conclusions: These results can be used to design a Health Intervention Program targeting to upgrade the maternal health practices and ultimately progress the health status of the women.

Antenatal Care in Sudan: A Qualitative Study Into Accessibility and Quality of Maternal Health Services in Khartoum

2018 ◽  
Vol 8 (2) ◽  
pp. 77-86
Author(s):  
Rayan Mohamed-Ahmed ◽  
Muna Abdel Aziz ◽  
Richard Walker
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Antenatal Care ◽  
Cost Effective ◽  
Maternal Health Services ◽  
Modern Medicine ◽  
Group Discussions ◽  
Maternal Deaths ◽  
Physical Barriers

Antenatal care is shown to be a cost-effective intervention for reducing rates of maternal mortality. However, utilization of maternal health services in Sudan remains low and maternal deaths high. This study aims to investigate why Sudanese women do not attend antenatal care, satisfaction with services and views on improving uptake. Focus group discussions took place, with 30 women who had delivered in the past year, in five areas in Khartoum. Themes in transcripts were identified. Factors that can affect a woman’s choice to attend antenatal care extend beyond physical barriers and include misconceptions of it’s use, conflict between faith and modern medicine and dissatisfaction with previously used services. The care provider’s perceived lack of empathy, unpunctuality and lack of health promotion can also contribute to underutilization.

scholarly journals Developing targeted client communication messages to pregnant women in Bangladesh: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jesmin Pervin ◽  
Bidhan Krishna Sarker ◽  
U. Tin Nu ◽  
Fatema Khatun ◽  
A. M. Quaiyum Rahman ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Text Messages ◽  
Care Utilization ◽  
Behavior Change Techniques ◽  
Lack Of Information ◽  
Antenatal Care Utilization ◽  
Client Communication ◽  
Study Participants

Abstract Background Timely and appropriate evidence-based practices during antenatal care improve maternal and neonatal health. There is a lack of information on how pregnant women and families perceive antenatal care in Bangladesh. The aim of our study was to develop targeted client communication via text messages for increasing antenatal care utilization, as part of an implementation of an electronic registry for maternal and child health. Methods Using a phenomenological approach, we conducted this qualitative study from May to June 2017 in two sub-districts of Chandpur district, Bangladesh. We selected study participants by purposive sampling. A total of 24 in-depth interviews were conducted with pregnant women (n = 10), lactating women (n = 5), husbands (n = 5), and mothers-in-law (n = 4). The Health Belief Model (HBM) was used to guide the data collection. Thematic analysis was carried out manually according to the HBM constructs. We used behavior change techniques to inform the development of targeted client communication based on the thematic results. Results Almost no respondents mentioned antenatal care as a preventive form of care, and only perceived it as necessary if any complications developed during pregnancy. Knowledge of the content of antenatal care (ANC) and pregnancy complications was low. Women reported a variety of reasons for not attending ANC, including the lack of information on the timing of ANC; lack of decision-making power; long-distance to access care; being busy with household chores, and not being satisfied with the treatment by health care providers. Study participants recommended phone calls as their preferred communication strategy when asked to choose between the phone call and text message, but saw text messages as a feasible option. Based on the findings, we developed a library of 43 automatically customizable text messages to increase ANC utilization. Conclusions Pregnant women and family members had limited knowledge about antenatal care and pregnancy complications. Effective health information through text messages could increase awareness of antenatal care among the pregnant women in Bangladesh. This study presents an example of designing targeted client communication to increase antenatal care utilization within formal scientific frameworks, including a taxonomy of behavior change techniques. Trial registration ISRCTN69491836. Registered on December 06, 2018. Retrospectively registered.

scholarly journals Ending malnutrition in all its forms requires scaling up proven nutrition interventions and much more: a 129-country analysis

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Nick Scott ◽  
Dominic Delport ◽  
Samuel Hainsworth ◽  
Ruth Pearson ◽  
Christopher Morgan ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Vitamin A ◽  
Pregnant Women ◽  
Cost Effective ◽  
Scaling Up ◽  
Folic Acid Supplementation ◽  
Nutrition Interventions ◽  
Vitamin A Supplementation ◽  
The Impact ◽  
Total Impact

Abstract Background Sustainable Development Goal (SDG) 2.2 calls for an end to all forms of malnutrition, with 2025 targets of a 40% reduction in stunting (relative to 2012), for wasting to occur in less than 5% of children, and for a 50% reduction in anaemia in women (15–49 years). We assessed the likelihood of countries reaching these targets by scaling up proven interventions and identified priority interventions, based on cost-effectiveness. Methods For 129 countries, the Optima Nutrition model was used to compare 2019–2030 nutrition outcomes between a status quo (maintained intervention coverage) scenario and a scenario where outcome-specific interventions were scaled up to 95% coverage over 5 years. The average cost-effectiveness of each intervention was calculated as it was added to an expanding package of interventions. Results Of the 129 countries modelled, 46 (36%), 66 (51%) and 0 (0%) were on track to achieve the stunting, wasting and anaemia targets respectively. Scaling up 18 nutrition interventions increased the number of countries reaching the SDG 2.2 targets to 50 (39%), 83 (64%) and 7 (5%) respectively. Intermittent preventative treatment of malaria during pregnancy (IPTp), infant and young child feeding education, vitamin A supplementation and lipid-based nutrition supplements for children produced 88% of the total impact on stunting, with average costs per case averted of US$103, US$267, US$556 and US$1795 when interventions were consecutively scaled up, respectively. Vitamin A supplementation and cash transfers produced 100% of the total global impact on prevention of wasting, with average costs per case averted of US$1989 and US$19,427, respectively. IPTp, iron and folic acid supplementation for non-pregnant women, and multiple micronutrient supplementation for pregnant women produced 85% of the total impact on anaemia prevalence, with average costs per case averted of US$9, US$35 and US$47, respectively. Conclusions Prioritising nutrition investment to the most cost-effective interventions within the country context can maximise the impact of funding. A greater focus on complementing nutrition-specific interventions with nutrition-sensitive ones that address the social determinants of health is critical to reach the SDG targets.

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