Cost-effectiveness of program to improve nutrition in pregnant women from low-income groups

It is common knowledge that improper nutrition and obesity during pregnancy can lead to many serious health shortcomings for infants as well as mothers. Malnutrition in mothers during prenatal period is related to many chronic as well as acute diseases. Any program that focuses on proper maternal nutrition and physical activity and intervenes at an early fetal development stage may deliver better health results for infants and mothers. Investing in maternal and child health will ultimately lead to improved outcomes in terms of longevity as well as quality of life. However, the question is not simply are there benefits, but whether those benefits are worth the costs. Accordingly, the intent of this study was to determine whether a program focused on physical activity and better dietary habits for pregnant women is able to improve the quality of life for mothers (particularly by decreasing incidences of postpartum depression) and help deliver better birth outcomes. The main purpose and important aspect of the study was to carry out an economic evaluation using cost-effectiveness analysis. This was done by estimating the costs associated with carrying out the intervention and the enhancement seen in the quality of life due to the same. Healthy Eating Active Living (HEAL) was a primary prevention program with the overarching goal of increasing healthy eating, breastfeeding and physical activity behaviors to promote healthy weight gain during pregnancy for the mother, improve birth outcomes and prevent childhood obesity later in life. The program was carried out with 244 pregnant female participants living in and around Houston, Texas. All of these women who participated in the study belonged to low-income groups and were eligible for Medicaid. The costs of conducting the program were calculated in terms of staff costs, material costs and participants cost. Participants’ health was measured in terms of Quality Adjusted Life Years (QALYs) with the aid of EuroQol-5D set of questionnaire, before and after the intervention. This was done to assess the quality of life before and after intervention with respect to postpartum depression. Cost-effectiveness was calculated in terms of costs per unit increase in QALY. The cost of conducting the program per participant was found to be $283. This further led to incremental costs of conducting the program to be $9,399 per unit increase in QALY. This is fairly cost-effective considering the threshold of $50,000 per unit of QALY. Therefore, it was concluded that HEAL program was cost-effective