student

1. Qn. Looking at Uganda’s health sector and
national priorities, evaluate the economic
impact of preventive nutrition and health
care measures on long –term health care
costs?
Akia Anna Mary S21B37/030
Nansereko Gloria S21B37/016
Oryem John Bosco S20B37/038
Oryema Patrick S20B37/020
Omony Samuel Okumu S20B37/002
Francis Obali S20B37/024
Natuhwera Aisha S19B37/026
Yake Michael S20B37/025

2. • Many preventive health interventions may be highly cost-effective for
Uganda’s government (Adams et al., 2023). Some promote health and
reduce costs overall because of the reduced need to treat expensive
diseases. Others allow us to live longer with better quality of life, and
come at a reasonable cost to the health system.
• According to (McFadyen et al., 2018), most preventive health
strategies lead to cost savings that far outweighs the cost of their
implementation. Research shows that cost savings have been
achieved particularly from multiple strategies in tobacco control, but
also from interventions targeting physical activity, diet and obesity.

3. • The types of interventions that are particularly cost-effective tend to have
the largest population health impact. These include regulatory strategies,
such as mandatory salt reduction and reformulation, restrictions on
advertising unhealthy food to children, tobacco control restrictions, and
fiscal interventions such as taxation of unhealthy or harmful products like
tobacco, alcohol and sugary drinks.
• According to the Uganda Vision 2040, aims to transform Uganda into a
"developed and competitive country" by 2040 and thus investing in
preventive healthcare can create a healthier, more productive population.
Furthermore, National Development Plan III (NDP III), Prioritizes improving
health outcomes and achieving Universal Health Coverage (UHC) and
therefore preventive measures can contribute to a more efficient and
sustainable healthcare system (Government of Uganda, 2020)

4. • Government spending and budget allocation: The government's
commitment to funding preventive healthcare measures is crucial. Adequate
budget allocation to nutrition programs, immunization campaigns, and
primary healthcare facilities can amplify the economic benefits of preventive
interventions by reaching a larger portion of the population.
• Disease Burden: Uganda faces a high burden of preventable diseases. the
most deaths due to communicable diseases for all ages are: neonatal
disorders, Malaria, HIV/AIDS, Lower respiratory infect, tuberculosis, diarrheal
diseases, STIs and Meningitis. For non-communicable diseases the causes are
mostly, stroke, ischemic heart disease and congenital defects. For all diseases
the % change is negative except for ischemic heart (Murray et al., 2001).
Preventive measures can significantly reduce the incidence and severity of
these diseases, thus lowering the long-term healthcare costs associated with
their treatment. In agreement with WHO (2017), NCDs are costly to treat and
therefore studies show that preventive measures like promoting healthy diets,
increasing physical activity, and tobacco control can significantly reduce the
prevalence of NCDs, leading to substantial healthcare cost savings.

5. • Preventive nutrition and health care measures can have a significant impact
on long-term health costs in Uganda. According to the World Health
Organization (WHO), investing in prevention can reduce the burden of
disease and injuries, and lead to better health outcomes and economic
benefits (World Health Organization, 2019).
• Additionally, the introduction of rotavirus vaccination in Uganda has been
estimated to prevent 17,000 hospitalizations and save $3.5 million in direct
medical costs annually (Kabakyenga et al., 2019).
• Investing in maternal and child nutrition programs can reduce childhood
illnesses, hospitalizations, and future healthcare needs (Bhutta, et al., 2013).
Preventive nutrition measures, such as promoting breastfeeding and
providing micronutrient supplementation, can also have a significant impact
on long-term health costs.

6. • The WHO recommends exclusive breastfeeding for the first six months of life,
which has been shown to reduce the risk of infectious diseases and improve
cognitive development (World Health Organization, 2019). In Uganda, a study
found that promoting exclusive breastfeeding could save an estimated $6
million annually in treatment costs for diarrhea and pneumonia (Bahl et al.,
2007).
• Micronutrient supplementation can also improve health outcomes and reduce
long-term health costs. A study in Uganda found that providing iron and folic
acid supplements to pregnant women reduced the risk of low birth weight
and preterm birth, which can lead to long-term health complications
(Tumwine et al., 2018). Additionally, providing vitamin A supplements to
children under five has been shown to reduce mortality rates by up to 24%
(World Health Organization, 2019).
• Investing in preventive measures can also have broader economic benefits. A
study by the World Bank found that investing in early childhood development
programs, including nutrition and health interventions, can have a return on
investment of up to 17% per year (World Bank, 2018).

7. • Cost of treatment in comparison with Prevention: Preventive measures such as
vaccinations, nutritional supplementation, prenatal care, and public health
campaigns are generally less expensive than treating advanced stages of diseases.
Investing in preventive healthcare can lead to substantial savings in healthcare
expenditure over the long term.
• A systematic review published in PLOS Medicine found that investment in preventive
interventions such as childhood immunization, tobacco control, and dietary salt
reduction can result in substantial cost savings in healthcare expenditure over time
(Woods et al., 2016). By reducing the incidence of preventable diseases through
nutrition and healthcare interventions, Uganda can lower its healthcare spending
and allocate resources more efficiently to other critical areas.
• Productivity loss: Illnesses and diseases not only impose direct healthcare costs but
also result in productivity losses due to absenteeism, disability, and premature
mortality. A study published in The Lancet estimated that every dollar invested in
scaling up interventions to address NCDs in low- and middle-income countries could
generate a return of at least $7 in increased employment and productivity by 2030
(Nugent et al., 2018). By prioritizing preventive nutrition and healthcare, Uganda can
create a more productive workforce, fostering economic development in the long
run. A healthy population leads to a more productive workforce, boosting economic
growth.

8. • Healthcare infrastructure: Preventive measures can alleviate the strain on
healthcare infrastructure by reducing the demand for hospital beds, medical
personnel, and specialized equipment. This can free up resources that can
be allocated to other areas of healthcare or infrastructure development,
potentially boosting economic growth.
• Long-term impact: While the benefits of preventive healthcare may not be
immediately apparent, they accrue over the long term. Investing in
preventive measures today can yield significant cost savings in the future by
averting costly medical interventions, hospitalizations, and long-term care.
• Social and human development: Improved health outcomes contribute to
broader social and human development by reducing poverty, improving
educational attainment, and fostering economic empowerment, particularly
among vulnerable populations such as women and children.

9. • International Aid and Partnerships: Uganda receives substantial international
aid and support for its healthcare programs. Strengthening preventive
measures can enhance the effectiveness of these investments and promote
sustainable development in the health sector.
• Enhanced Human Capital Development: Investing in preventive nutrition and
healthcare contributes to the development of human capital by ensuring that
children grow up healthy and are better equipped to learn and contribute to
the economy. The World Bank estimates that poor health reduces GDP growth
by 0.25-0.50 percentage points annually in low-income countries, highlighting
the importance of health in human capital development and economic
progress (World Bank, 2018).
• By prioritizing preventive measures, Uganda can enhance its human capital
base, leading to sustained economic development in the long term.

10. • References:
• Adams, K. P., Vosti, S. A., Arnold, C. D., Engle-Stone, R., Prado, E. L., Stewart, C. P., ... & Dewey,
K. G. (2023). The cost-effectiveness of small-quantity lipid-based nutrient supplements for
prevention of child death and malnutrition and promotion of healthy development: modelling
results for Uganda. Public Health Nutrition, 26(10), 2083-2095.
• Murray, C. J., Lopez, A. D., Mathers, C. D., & Stein, C. (2001). The Global Burden of Disease 2000
project: aims, methods and data sources. Geneva: World Health Organization, 36, 1-57.
• McFadyen, T., Chai, L. K., Wyse, R., Kingsland, M., Yoong, S. L., Clinton-McHarg, T., ... &
Wolfenden, L. (2018). Strategies to improve the implementation of policies, practices or
programmes in sporting organisations targeting poor diet, physical inactivity, obesity, risky
alcohol use or tobacco use: a systematic review. BMJ open, 8(9), e019151.
• Bahl, R., Martine, J., & Gribble, L. (2007). Estimating infant mortality reduction from promotion
of exclusive breastfeeding: A review of evidence from observational studies. Maternal & Child
Nutrition, 3(2), 75-88.
• Kabakyenga, J., Nsubuga, P., Nankabirwa, J., Kizito, S., & Friberg, I. K. (2019). Rotavirus vaccine
impact assessment in Uganda: Hospitalizations prevented by rotavirus vaccination through
routine immunization services. Vaccine Impact Modelling Consortium Report Series.
• Olmsted, S., Menzies, N., Pacey Anna C., & Eaton John W. (2018). The cost-effectiveness of
measles vaccine introduction in low-income countries: A systematic review of model estimates
from 1995 to 2016.

11. • Tumwine JKN et al. (2018) Effectiveness of antenatal multiple micronutrient
supplementation on maternal morbidity and mortality: a community randomized trial in
rural eastern Uganda - MUAC trial cluster randomized controlled trial
• World Health Organization (WHO). (2021). Global action plan for the prevention and control
of no communicable diseases 2013-2020.
• Nugent, R., Bertram, M. Y., Jan, S., Niessen, L. W., & Sassi, F. (2018). Investing in non-
communicable disease prevention and management to advance the Sustainable
Development Goals. The Lancet, 391(10134), 2029-2035.
• Woods, B., Revill, P., Sculpher, M., & Claxton, K. (2016). Country-Level Cost-Effectiveness
Thresholds: Initial Estimates and the Need for Further Research.
• World Bank. (2018). World development report 2019: the changing nature of work.
Washington, DC: World Bank.
• World Health Organization (WHO). (2017). Global action plan for the prevention and control
of non-communicable diseases 2013-2030.
• Bhutta, Z. A., Black, R. E., de Onis, M., Ezzati, M., Fawzi, V. W., Guerrant, R. L., ... & Walker, S.
P. (2013). Maternal and child nutrition interventions: priorities for action and measurement.
The Lancet, 382(9890), 462-471.
• Government of Uganda. (2020). National Development Plan III (2021/22-2025/26).
• Uganda vision, (2040).