Malnutrition, which refers to deficiencies, excesses, or imbalances in nutrient intake, affects billions of people around the world. There are various forms of malnutrition, including undernutrition, micronutrient-related malnutrition, and overweight, obesity, and diet-related non-communicable diseases. In addition to serious health consequences, the global burden of malnutrition has lasting social and economic impacts for individuals and communities. Combating malnutrition requires a coordinated effort across sectors, involving collaboration and knowledge-sharing beyond the healthcare industry. 

Since 2019, Strengthening Economic Evaluation for Multisectoral Strategies for Nutrition (SEEMS-Nutrition), a project based at the Global Center for the Integrated Health of Women, Adolescents, and Children (Global WACh)—one of the 20+ centers, programs, and initiatives within the UW Department of Global Health—has worked in partnership with several organizations to address information gaps regarding the costs, benefits, and cost-effectiveness of scaling up food system strategies in resource-constrained areas. In honor of National Nutrition Month, we delve deeper into SEEMS-Nutrition.  

Too often the conversation about nutrition centers around what we eat. However, “nutritional outcomes are determined by interactions between dietary intake and disease at the individual level, as well as household food security, improved care and feeding practices, and access to a healthy environment,” said Dr. Carol Levin, Project Director of SEEMS-Nutrition and Clinical Associate Professor of Global Health. “Multisectoral approaches that address poverty, enhance livelihoods, improve food systems, water sanitation and hygiene, and access to health services have the greatest potential for significant and lasting improvements for maternal and child nutritional status,” explained Dr. Levin.  

Currently there is limited data on the impact, costs and return on investment on a multisectoral approach. This lack of evidence impedes policy makers and program managers from making informed decisions about what interventions to prioritize to improve nutrition outcomes. 

To address this problem, SEEMS-Nutrition developed a standardized approach for conducting cost studies that aims to strengthen the design and implementation of economic evaluations. In November 2023, they published a guidance document that can be applied by field researchers, evaluators, and implementers to generate improved evidence for nutrition interventions extending across various sectors beyond public health and healthcare.  

“This initiative fills a huge gap in understanding costs of complex nutrition programs through the development of standardized tools for researchers, policy makers, and practitioners” said Esther Choo, who graduated from DGH’s PhD in Implementation Science program in 2023 and joined the SEEMS-Nutrition project team 3 years ago. “We used these tools across seven different projects and contexts to compare costs across interventions.”  

In Malawi, researchers examined the economic costs of an integrated agriculture and nutrition home-grown preschool meal intervention. Similarly, in Bangladesh, researchers investigated the economic costs of a multisectoral nutrition program implemented through a gender empowerment platform. These results demonstrated the value of a standardized costing approach for comparison with other multisectoral nutrition interventions to enhance comparability, applicability, and transparency for use in evaluation and policymaking. The findings and guidance resulting from the SEEMS-Nutrition project can ultimately help improve dietary intake and nutritional status while also contributing to healthy food systems globally. “It has truly been humbling and exciting to be part of this groundbreaking work,” Choo exclaimed. 

This National Nutrition Month, we recognize the advances made in addressing global malnutrition, and reaffirm our commitment to improve health for all. Find more information about the SEEMS-Nutrition project here

By Sophie Li