Integrating Cost-Effectiveness into Nutrition Programming Decisions of Specialized Nutritious Foods: An Evidence-Informed Interactive Tool

Abstract Objectives An interactive Food Assistance Cost-Effectiveness Tool (FACET) was created to support funders and implementing partners of selected nutrition programs involving specialized nutritious foods (SNF) to factor cost-effectiveness into programming decisions in development and humanitarian contexts. Methods Built with the Shiny package in R, the FACET interface guides users through the process of integrating user-provided data and scientific evidence into program decision-making under a cost-effectiveness framework. Users create a scenario by inputting choices or values for program, cost, and impact parameters, while the back-end algorithms calculate a list of quantity, cost, and cost-effectiveness indicators. Users can then create multiple scenarios to compare across alternative program designs, product choices, or procurement channels. Tool inputs and outputs of the scenarios can be saved and downloaded into a spreadsheet. Whenever possible, FACET provides data visualizations of, or direct links to, data sources and references such as USAID historical product procurement costs, scientific literature on program impacts, and other relevant guidance. Users have the flexibility to use their data sources to develop model parameters if deemed more appropriate. Throughout the FACET interface and user manual development, extensive feedback was gathered from USAID, international agencies, implementation organizations, research institutions, etc. Results User engagement has helped identify applications of the FACET tool: 1.Throughout the programming cycle, e.g., during proposal development (by implementing partners), during proposal reviews (by funders), for end-line reporting (by implementing partners), and for program reviews (by implementing partners and funders);2.New SNF product vetting, e.g., assessing the extent to which promising new products can ‘compete’ with existing products in terms of cost-effectiveness. Conclusions FACET brings together diverse expertise and available data and strengthens nutrition program funders and implementing partners’ decision-making capacity around cost-effectiveness. The development of FACET serves as an example of how the research community can facilitate bringing data/evidence into real-world decision-making. Funding Sources United States Agency for International Development.