PROFILES CALCULATOR: Neonatal and Postneonatal Infant Heath Care Savings from Reducing Low Birth Weight (LBW)

In this model we distinguish between neonatal (first month) and postneonatal infant and child (1 through 24 months) care. For neonatal care the model is based on data from Bangladesh where the resource cost for longer hospitalization for a LBW baby is estimated at $209 (Alderman and Behrman 2004). This value is not discounted and includes $15 for the costs to the family for the extended hospital stay as well as distortion costs of 25% from "raising governmental revenues to finance the subsidized hospitalization and from inducing inefficient use of resources through their subsidized hospitalization."

In many low income countries most LBW babies are born at home. For these babies the additional costs associated with LBW are relatively minor. Following Alderman and Behrman, we assume, in the default case, that 10% of LBW babies are born in the hospital and will incur the additional costs of $209. The remaining proportion (90%) are born at home and additional cost of their care is assumed to be only 10% of that for those born in hospitals (10% of $209=$20.9).

Although they cite evidence of an increase in morbidity beyond the neonatal period for infants and children born with LBW, Alderman and Behrman were not able to find good estimates in the literature of the total costs of these LBW-related illnesses. Their own estimate is $40 per LBW infant, centered at one year of age and includes their estimates of direct out-of-pocket expenses to the family, the costs of subsidized medical care and the opportunity cost of caregivers diverted from other important activities. We use the number of births less the neonatal deaths as a proxy for the number of infants and young children at risk in a given year, reasoning that although this may overestimate the number of surviving children at risk, by including all live births the costs of care associated with illnesses that lead to death are also captured.

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INSTRUCTIONS: Boxes in yellow should be filled in by the user. Click on the box and enter data for the country of your choice. Then click the 'Get Results' button to see the results in the boxes shaded in blue. The assumptions can be changed by the user if the default values are deemed inaccurate.
Inputs
1. Prevalence of Low Birth Weight (%)
2. Births per year
3. Neonatal mortality rate (deaths <1 month/1000 live births)
   
Assumptions
1. Cost of LBW-related neonatal care for infants born in health facilities ($/LBW neonate)
2. Proportion of LBW births occuring in health facilities
3. Cost of LBW-related neonatal care for infants born at home (as proportion of facility costs)
4. Cost of additional postneonatal LBW-related care for infants and children ($/LBW infant)
   
Intermediate results
1. Cost of LBW-related neonatal care for infants born in health facilities ($/year)
2. Cost of LBW-related neonatal care for infants born at home ($/year)
   
Results
1. Cost of LBW-related neonatal care ($/year)
2. Cost of LBW-related postneonatal care ($/year)
3. Total cost of LBW-related infant and child medical care ($/year)

References

Alderman H, Behrman JR. Estimated economic benefits of reducing Low Birth Weight in Low-Income Countries. Health, Nutrition and Population (HNP) Discussion Paper. Washington, DC: The World Bank, 2004.

Ashworth A. Effects of intrauterine growth retardation on mortality and morbidity in infants and young children. As presented at the 1996 IDECG Workshop in Baton Rouge and edited by the European Journal of Clinical Nutrition Volume 52, Supplement 1, January 1998

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