Evidence mapPaperPMID 40221139Full record

ArticleBMJ global health2025

Benefit-cost analysis of an integrated package of interventions during preconception, pregnancy and early childhood in India.

Tarun Shankar Choudhary, Sarmila Mazumder, Sunita Taneja, Ranadip Chowdhury, Ravi Prakash Upadhyay, Sitanshi Sharma, Neeta Dhabhai, Ole Frithjof Norheim, Nita Bhandari, Kjell Arne Johansson

Abstract read
In one paragraph

Article in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Tarun Shankar ChoudharyCentre for Intervention Science in Maternal and Child Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.ORCID http://orcid.org/0000-0003-0093-8341
Sarmila MazumderSociety for Applied Studies, New Delhi, India sarmila.mazumder@sas.org.in.
Sunita TanejaSociety for Applied Studies, New Delhi, India.
Ranadip ChowdhurySociety for Applied Studies, New Delhi, India.
Ravi Prakash UpadhyaySociety for Applied Studies, New Delhi, India.
Sitanshi SharmaSociety for Applied Studies, New Delhi, India.
Neeta DhabhaiSociety for Applied Studies, New Delhi, India.
Ole Frithjof NorheimCentre for Intervention Science in Maternal and Child Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Nita BhandariSociety for Applied Studies, New Delhi, India.ORCID http://orcid.org/0000-0003-0349-087X
Kjell Arne JohanssonCentre for Intervention Science in Maternal and Child Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.ORCID http://orcid.org/0000-0001-8912-8710

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe have previously shown that an integrated intervention package delivered during preconception, pregnancy and early childhood substantially reduces low birth weight and stunting at 24 months of age compared with routine care. Now we conduct a benefit-cost analysis to estimate the return on investment of this integrated approach in India. This increases the policy relevance of trial results, given the low investment in healthcare in India.

methodsWe used data from 13 500 participants in the Women and Infant Integrated Interventions for Growth Study (WINGS). Integrated delivery of healthcare, nutrition, water, sanitation and hygiene (WaSH), and psychosocial care interventions during preconception period, or pregnancy and early childhood, or both (full package), was compared with routine care. We converted reduction in mortality, morbidity and increase in productivity to monetary values and calculated the benefit-cost ratio. We used primary and secondary trial health outcomes from the WINGS trial to calculate benefits, and we collected costs prospectively during the trial. Uncertainty was explored in a one-way sensitivity analysis. We applied a discount rate of 3% per annum to both costs and benefits, considering the purchasing power parity (PPP) of US dollars in 2021.

resultsEvery dollar invested returned 6.1$ PPP for interventions during preconception, 9.9$ PPP for pregnancy and early childhood interventions and 3.7$ PPP for the full package of interventions compared with routine care in the base case scenario. The return to investment was positive (>4.6$ PPP per 1$ PPP invested) for pregnancy and early childhood interventions in all scenarios of the sensitivity analysis. The net monetary benefits of the interventions ranged between 7364 and 25 917$ PPP.

conclusionOur results suggest that integrated and concurrent delivery of healthcare, nutrition, WaSH and psychosocial care interventions during pregnancy and early childhood yield positive economic returns.

Indexed as

Growth DisordersPreconception CarePrenatal CareAdultChild, PreschoolCost-Benefit AnalysisFemaleHumansIndiaInfantInfant, Low Birth WeightInfant, NewbornPregnancyHealth economicsPublic Health

Identifiers

PMID40221139
PMCPMC11997828

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.