| A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | AA | AB | AC | AD | AE | AF | AG | AH | AI | AJ | AK | |
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1 | Cost-effectiveness estimates | Helen Keller International | |||||||||||||||||||||||||||||||||||
2 | |||||||||||||||||||||||||||||||||||||
3 | Summary DALY estimation | ||||||||||||||||||||||||||||||||||||
4 | Burkina Faso | Cameroon | Cote d'Ivoire | DR Congo | Guinea | Kenya | Madagascar | Mali | Niger | Nigeria | Mozambique | Sierra Leone | Tanzania | ||||||||||||||||||||||||
5 | Number of children reached in 2024 | 1,316,733 | 6,268,341 | 4,275,333 | 10,650,495 | 1,901,834 | 3,345,489 | 2,933,358 | 2,172,619 | 5,438,281 | 5,640,455 | 588,380 | 415,070 | 455,450 | |||||||||||||||||||||||
6 | Under five mortality in a year | 55,356 | 63,046 | 65,790 | 306,481 | 45,350 | 59,036 | 63,429 | 83,597 | 119,782 | 768,479 | 75,675 | 23,993 | 89,057 | |||||||||||||||||||||||
7 | Total unbder five children | 3,965,835 | 5,119,261 | 5,405,956 | 22,226,497 | 2,556,226 | 8,285,329 | 5,328,957 | 4,831,874 | 5,414,959 | 39,351,433 | 6,580,812 | 1,360,592 | 12,550,745 | |||||||||||||||||||||||
8 | Total expected death among the intervention children | 18,379 | 77,197 | 52,030 | 146,860 | 33,740 | 23,838 | 34,915 | 37,589 | 120,298 | 110,150 | 6,766 | 7,319 | 3,232 | |||||||||||||||||||||||
9 | Total death prevented | 1,102.76 | 4,631.85 | 3,121.83 | 8,811.58 | 2,024.43 | 1,430.27 | 2,094.89 | 2,255.33 | 7,217.87 | 6,609.02 | 405.96 | 439.17 | 193.91 | |||||||||||||||||||||||
10 | Life expectancy at age 2.5 years | 61.6 | 63.26 | 61.36 | 65.45 | 61.88 | 61.33 | 63.03 | 61.44 | 64.06 | 68.2 | 62.93 | 63.35 | 64.85 | |||||||||||||||||||||||
11 | Discounted life expenctancy at age 2.5 years | 27.9 | 28.2 | 27.9 | 28.5 | 28 | 27.9 | 28.2 | 27.9 | 28.3 | 28.9 | 28.1 | 28.2 | 28.4 | |||||||||||||||||||||||
12 | Total DALYs averted from deaths | 30,767 | 130,618 | 87,099 | 251,130 | 56,684 | 39,905 | 59,076 | 62,924 | 204,266 | 191,001 | 11,407 | 12,384 | 5,507 | |||||||||||||||||||||||
13 | Total costs of the intervention | 1,250,152 | 6,813,006 | 3,805,351 | 4,692,206 | 3,348,142 | 2,791,779 | 1,113,163 | 2,086,671 | 2,533,343 | 3,173,446 | 1,578,937 | 364,111 | 683,326 | |||||||||||||||||||||||
14 | Costs per DALY averted US$ | 40.63 | 52.16 | 43.69 | 18.68 | 59.07 | 69.96 | 18.84 | 33.16 | 12.40 | 16.61 | 138.41 | 29.40 | 124.08 | |||||||||||||||||||||||
15 | Costs per DALY averted without discounting (US$) | 18.4 | 23.3 | 19.9 | 8.1 | 26.7 | 31.8 | 8.4 | 15.1 | 5.5 | 7.0 | 61.8 | 13.1 | 54.3 | |||||||||||||||||||||||
16 | GDP per capita US$ PPP | 2,896.2 | 7,653.5 | 5,591.5 | 1,709.7 | 4,579.1 | 6,619.4 | 1,883.5 | 3,308.7 | 2,015.0 | 6,439.8 | 1,699.7 | 3,515.6 | 4,220.8 | |||||||||||||||||||||||
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21 | Please note the monitoring data figures were not subject to internal validation prior to being shared with The Life You Can Save and may change. | ||||||||||||||||||||||||||||||||||||
22 | Monitoring data | ||||||||||||||||||||||||||||||||||||
23 | Name of the country | Burkina Faso | Cameroon | Cote d'Ivoire | DR Congo | Guinea | Kenya | Madagascar | Mali | Niger | Nigeria | Mozambique | Senegal | Sierra Leone | Tanzania | Comments | |||||||||||||||||||||
24 | Year | S2(2023) /S1(2024) | S2(2023) /S1(2024) | S2(2023) /S1(2024) | S2(2023) /S1(2024) | S2(2023) /S1(2024) | S2(2023) /S1(2024) | S2(2023) /S1(2024) | S2(2023) /S1(2024) | S2(2023) /S1(2024) | S2(2023) /S1(2024) | S2(2023) /S1(2024) | S2(2023) /S1(2024) | S2(2023) /S1(2024) | S2(2023) /S1(2024) | S1: First semester 2024 S2: Second semester 2023 | |||||||||||||||||||||
25 | Name of the programme | Vitamin A supplementation | |||||||||||||||||||||||||||||||||||
26 | Brief description of the programme | Since the 1980s, Helen Keller Intl has been at the forefront of demonstrating that twice-yearly vitamin A supplementation (VAS) can reduce child mortality by up to 24% when it reaches at least 80% of children under five in areas where vitamin A deficiency is a public health concern. Building on WHO’s 1997 recommendation for universal VAS in such contexts, coverage across sub-Saharan Africa exceeded 80% from the early 2000s through large-scale, door-to-door campaigns, many of them linked to polio immunization. However, with the phase-out of polio campaigns since 2016, coverage has declined as efforts shifted towards routine facility-based delivery, which has struggled to reach older children. Helen Keller now supports 14 countries in sub-Saharan Africa to sustain VAS, testing alternative delivery models—including outreach, facility-based integration, and continued door-to-door campaigns with added services such as deworming and malnutrition screening. Despite persistent challenges in cost, complexity, and health system capacity, Helen Keller remains committed to working with governments to build sustainable, high-impact delivery approaches that ensure this life-saving intervention continues to reach children in need. | |||||||||||||||||||||||||||||||||||
27 | Objective of the programme | 1. All countries will have, at least, identified, tested and documented a country-specific sustainable and cost-effective delivery model for VAS that is fully integrated in health system 2. All countries will have developed and started implementing a transition plan for VAS towards a cost-effective and sustainable model 3. Global evidence will have increased on cost effective and sustainable delivery models for VAS 4.The proportion of VAS services costs covered by domestic funding will have increased | |||||||||||||||||||||||||||||||||||
28 | Outcome description | 1. Coverage of VAS>80% of children under five 2. VAS service funded and supported by local goevrnments 3. Increased efficiency of health system functions and actors 4. Increased evidence of cost-effective delivery models for VAS | |||||||||||||||||||||||||||||||||||
29 | Target group (age specific/description) | Children aged from 6 to 59 months | |||||||||||||||||||||||||||||||||||
30 | Total Target Population by age group/target group in number for the second semester 2023 | 1,092,488 | 5,833,851 | 3,236,348 | 8,006,201 | 2,413,615 | 3,716,143 | There is no support from Helen Keller. | 2,011,133 | 6,361,641 | 5,893,770 | 708,534 | Data were not available beacause of the strike of health worker | 495,467 | 352,073 | ||||||||||||||||||||||
31 | Number of children reached with VAS capusles during the second semester 2023 | 1,119,578 | 5,747,946 | 2,937,074 | 7,955,556 | 2,203,496 | 3,357,446 | There is no support from Helen Keller. | 1,872,364 | 5,438,281 | 5,544,101 | 668,664 | Data were not available beacause of the strike of health worker | 413,488 | 482,340 | ||||||||||||||||||||||
32 | Total Target Population by age group/target group in number for the first semester 2024 | 1,240,653 | 6,363,659 | 5,180,887 | 10,531,672 | 2,237,452 | 3,871,439 | 3,259,112 | 2,129,241 | 6,924,961 | 6,064,880 | 723,763 | Data were not available beacause of the strike of health worker | 506,859 | 367,298 | ||||||||||||||||||||||
33 | Number of children reached with VAS capusles during the first semester 2024 | 1,316,733 | 6,268,341 | 4,275,333 | 10,650,495 | 1,901,834 | 3,345,489 | 2,933,358 | 2,172,619 | 5,438,281 | 5,640,455 | 588,380 | Data were not available beacause of the strike of health worker | 415,070 | 455,450 | ||||||||||||||||||||||
34 | TOTAL Number of Vitamin A capsules distributed for the fiscal year 2024 | 2,436,311 | 12,016,287 | 7,212,407 | 18,606,051 | 4,105,330 | 6,702,935 | 2,933,358 | 4,044,983 | 10,876,562 | 11,184,556 | 1,257,044 | Data were not available beacause of the strike of health worker | 828,558 | 937,790 | ||||||||||||||||||||||
35 | Gender distribution of the beneficiaries | Not available | Data are not disaggregated by gender in all countries. | ||||||||||||||||||||||||||||||||||
36 | Programme start date | The data providded program started 1 st July 2023 and end the 30rd june 2024 | |||||||||||||||||||||||||||||||||||
37 | Duration of the programme | The information provided is linked to the duration of one year for the implementation of the program for the fiscal year 2024, which starts on July 1, 2023, and ends on June 30, 2024. | |||||||||||||||||||||||||||||||||||
38 | List of outcome indicators (prevention of morbidity / mortality; improvements in living standards, learning outcomes) | ||||||||||||||||||||||||||||||||||||
39 | Indicator 1 VAS Coverage | 1.1 % of eligible infants 6−11 months of age receiving an age-appropriate vitamin A supplement through event-based vitamin A distribution in the previous semester using administrative data. 1.2 % of eligible children 12−59 months of age receiving an age-appropriate vitamin A supplement through event-based vitamin A distribution in the previous semester using administrative data. 1.3 % of eligible infants 6−11 months of age receiving an age-appropriate vitamin A supplement through event-based vitamin A distribution in the previous semester using PECS data. 1.4 % of eligible children 12−59 months of age receiving an age-appropriate vitamin A supplement through event-based vitamin A distribution in the previous semester using PECS data. | |||||||||||||||||||||||||||||||||||
40 | Indicator 2 : Cost per Supplement | 2.1 Cost per supplement using administrative coverage. 2.2 Cost per supplement using PECS coverage. 2.3 Difference between costs reported using administrative data and PECS data. | |||||||||||||||||||||||||||||||||||
41 | Baseline status of the outcome indicators | ||||||||||||||||||||||||||||||||||||
42 | Indicator 1 fiscal year 2023 VAS coverage | 94% | 83% | 100% | 96% | 100% | 83% | No supoort from Helen Keller | 92% | 94% | 88% | 80% | 80% | 80% | 80% | ||||||||||||||||||||||
43 | Indicator 2 - no data available | ||||||||||||||||||||||||||||||||||||
44 | Endline status of the outcome indicators after evaluation or effect size of the programme after evaluation | ||||||||||||||||||||||||||||||||||||
45 | VAS coverage semester 2 2023 | 102% | 99% | 91% | 99% | 91% | 90% | No suport from Helen Keller | 93% | 85% | 94% | 94% | no data | 83% | 137% | ||||||||||||||||||||||
46 | VAS coverage semester 1 2024 | 106% | 99% | 83% | 101% | 85% | 86% | 90% | 102% | 79% | 93% | 81% | no data | 82% | 124% | ||||||||||||||||||||||
47 | Average | 104% | 99% | 87% | 100% | 88% | 88% | 90% | 98% | 82% | 94% | 88% | #DIV/0! | 83% | 131% | ||||||||||||||||||||||
48 | Cost of the programme/intervention in details | ||||||||||||||||||||||||||||||||||||
49 | Cost of capital items | 2443.51 | 106249 | 124511 | 120780 | 25339 | 108052 | 62075 | 57328 | 100610 | 160629 | 31996 | 13056 | 1315 | 0 | ||||||||||||||||||||||
50 | Costs of recurrent items | 1,247,709 | 6,706,757 | 3,680,840 | 4,571,426 | 3,322,803 | 2,683,727 | 1,051,088 | 2,029,343 | 2,432,733 | 3,012,817 | 1,546,941 | 519,203 | 362,796 | 683,326 | ||||||||||||||||||||||
51 | Total costs of the programme | 1,250,152 | 6,813,006 | 3,805,351 | 4,692,206 | 3,348,142 | 2,791,779 | 1,113,163 | 2,086,671 | 2,533,343 | 3,173,446 | 1,578,937 | 532,259 | 364,111 | 683,326 | ||||||||||||||||||||||
52 | Cost estimate timeframe ($) | The above cost is for one year the fiscal year 2024 | |||||||||||||||||||||||||||||||||||
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57 | Detailed estimations | ||||||||||||||||||||||||||||||||||||
58 | Burkina Faso | Cameroon | Cote d'Ivoire | DR Congo | Guinea | Kenya | Madagascar | Mali | Niger | Nigeria | Mozambique | Senegal | Sierra Leone | Tanzania | Comments | ||||||||||||||||||||||
59 | Additional number of chidren reached | 12% | 16% | -17% | 5% | -15% | 3% | 10% | -15% | 5% | 1% | 2% | 44% | ||||||||||||||||||||||||
60 | https://pmc.ncbi.nlm.nih.gov/articles/PMC8925277/ | ||||||||||||||||||||||||||||||||||||
61 | Under five mortality per 1000 live births | 77 | 67 | 67 | 73 | 95 | 40 | 65 | 91 | 115 | 105 | 62 | 39 | 94 | 39 | This study showed 12% reduction in all causes of death due to vitamine A difficiency | |||||||||||||||||||||
62 | Live births in thousands in a year | 729 | 957 | 997 | 4 370 | 488 | 1 500 | 1 001 | 951 | 1 096 | 7 510 | 1 261 | 532 | 259 | 2 346 | ||||||||||||||||||||||
63 | Total live births | 728,612 | 957,392 | 997,001 | 4,369,683 | 487,595 | 1,499,998 | 1,001,244 | 951,445 | 1,095,892 | 7,509,758 | 1,260,855 | 531,890 | 258,903 | 2,346,391 | ||||||||||||||||||||||
64 | Under five mortality rate per children | 0.11 | 0.07 | 0.07 | 0.02 | 0.19 | 0.03 | 0.06 | 0.10 | 0.10 | 0.01 | 0.05 | 0.07 | 0.36 | 0.02 | ||||||||||||||||||||||
65 | Expected total mortality in a year | 139,153 | 438,670 | 287,309 | 177,927 | 370,542 | 89,213 | 190,431 | 207,798 | 570,679 | 78,864 | 28,792 | 151,181 | 7,551 | |||||||||||||||||||||||
66 | Reported deaths in UNICEF data | 55,356 | 63,046 | 65,790 | 306,481 | 45,350 | 59,036 | 63,429 | 83,597 | 119,782 | 768,479 | 75,675 | 23,993 | 89,057 | |||||||||||||||||||||||
67 | Total under five children | 3,965,835 | 5,119,261 | 5,405,956 | 22,226,497 | 2,556,226 | 8,285,329 | 5,328,957 | 4,831,874 | 5,414,959 | 39,351,433 | 6,580,812 | 2,875,459 | 1,360,592 | 12,550,745 | ||||||||||||||||||||||
68 | Death rate | 0.0140 | 0.0123 | 0.0122 | 0.0138 | 0.0177 | 0.0071 | 0.0119 | 0.0173 | 0.0221 | 0.0195 | 0.0115 | - | 0.0176 | 0.0071 | ||||||||||||||||||||||
69 | Total death among the intervention population | 18,379 | 77,197 | 52,030 | 146,860 | 33,740 | 23,838 | 34,915 | 37,589 | 120,298 | 110,150 | 6,766 | 7,319 | 3,232 | |||||||||||||||||||||||
70 | Total death prevented | 1,102.76 | 4,631.85 | 3,121.83 | 8,811.58 | 2,024.43 | 1,430.27 | 2,094.89 | 2,255.33 | 7,217.87 | 6,609.02 | 405.96 | - | 439.17 | 193.91 | ||||||||||||||||||||||
71 | Life expectancy at birth | 61.092 | 63.7 | 61.944 | 61.895 | 60.74 | 63.646 | 63.632 | 60.439 | 61.183 | 54.462 | 63.611 | 61.786 | 66.995 | |||||||||||||||||||||||
72 | LE at avergae age at death 2.5 | 61.6 | 63.26 | 61.36 | 65.45 | 61.88 | 61.33 | 63.03 | 61.44 | 64.06 | 68.2 | 62.93 | 63.35 | 64.85 | |||||||||||||||||||||||
73 | Discounted at 3% | 27.9 | 28.2 | 27.9 | 28.5 | 28 | 27.9 | 28.2 | 27.9 | 28.3 | 28.9 | 28.1 | 28.2 | 28.4 | |||||||||||||||||||||||
74 | Total DALYs averted (six months protection) | 30,767 | 130,618 | 87,099 | 251,130 | 56,684 | 39,905 | 59,076 | 62,924 | 204,266 | 191,001 | 11,407 | - | 12,384 | 5,507 | ||||||||||||||||||||||
75 | Costs per DALY averted US$ | 40.63 | 52.16 | 43.69 | 18.68 | 59.07 | 69.96 | 18.84 | 33.16 | 12.40 | 16.61 | 138.41 | 29.40 | 124.08 | |||||||||||||||||||||||
76 | Prevalence of VAD | 86.6% | 39% | 30% | 61% | 25.90% | 62% | 45% | 36% | 25% | 29.50% | 72.10% | 48% | 17% | 69.50% | ||||||||||||||||||||||
77 | Source | Status report on vitamin A deficiency and associated factors in the health area of Sanmatenga province (Burkina Faso) | Research Square | https://www.unicef.org/cameroon/what-we-do/nutrition-0 | https://www.sante.gouv.ci/assets/fichiers/projet-de-supplementation-en-vitamine-a-et-de-deparasitage-des-enfants-de-6-a-59-mois-dans-24-districts-sanitaires.pdf | https://documents1.worldbank.org/curated/en/510801506583879408/pdf/120109-WP-ScalingUpNutritionDRCFINAL-PUBLIC.pdf | https://www.nutritionintl.org/wp-content/uploads/2023/02/Kenya-Country-Brief-Feb-2023-Digital.pdf | https://helenkellerintl.org/where-we-work/madagascar/ | https://wellsbringhope.org/the-long-term-battle-of-vitamin-a-deficiency-in-niger/ | https://www.nri.org/latest/news/2013/cassava-to-help-combat-vitamin-a-deficiency | https://www.researchgate.net/publication/8028201_Vitamin_A_deficiency_and_child_mortality_in_Mozambique | https://www.gava.org/content/user_files/2016/12/VAS-symposium-report.pdf | https://www.unicef.org/sierraleone/stories/community-health-workers-increase-vitamin-supplementation-vas-and-immunization-coverage | 8. Ndau, E, Mosha, T, Horton, S, and Laswai, H. Influence of vitamin A status on the anthropometric attributes of children aged 6-36 months in Tanzania. Tanzania J Agric Sci. (2018) 16 | ||||||||||||||||||||||||
78 | GDP per capita US$ PPP | 2896.187416 | 7653.450338 | 5591.496398 | 1709.732077 | 4579.101873 | 6619.358574 | 1883.537431 | 3308.669489 | 2015.022821 | 6439.812922 | 1699.705034 | 3515.562713 | 4220.796387 | |||||||||||||||||||||||
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