Findings from the cost effectiveness analysis
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Transcript of Findings from the cost effectiveness analysis
Findings from the cost effectiveness analysis
Clare Narrod, on behalf of the team
International Food Policy Research Institute International Center for the Improvement of Maize
and Wheat International Crops Research Institute for the Semi-Arid Tropics University of Pittsburgh
Uniformed Services University of the Health Sciences ACDI/VOCA/Kenya Maize Development Program Kenya Agricultural Research Institute Institut d’Economie Rurale The Eastern Africa Grain Council
• CEA evaluates the cost effectiveness of possible control decisions (options) on risk and health impacts
• Interested the least costly way to
reduce aflatoxin risk
Cost per unit
% Risk
Reduction
A
C
D
B
.
We estimate probability of aflatoxin contamination at each stage effectiveness of each technology
cost of each technology
When budgets are limited, keeping everything else equal, technologies that abate the greatest risks: are more effective
should be adopted first
Procedure Interventions Purpose/status/application
Pre-harvest Timing: planting and harvest Drought and pest resistant varieties Good agricultural practices
Avoid insect infestation which can serve as vectors for mould invasion; avoid plant stresses such as drought and other growth stress
Harvesting & Post harvest: drying and storage
Hand sorting-sun drying; storing bags on wooden pallets or elevated off ground; insecticides; rodent control
Reduce moisture levels and exposure to toxigenic moulds
Post-Harvest: food preparation
Physical separation of damaged, immature and mould-infested kernels, nuts, seeds etc
Effective in reducing aflatoxin levels in final product;
Effectiveness of these measures in practice under developing country conditions is not well understood.
In 2009 we implemented a 2-stage Delphi expert elicitation via email with a panel of experts to provide guidance on the effectiveness of selected aflatoxin control measures for maize and groundnut producers in the study countries.
Augmented information on effectiveness from literature.
Technique
Effectiveness (%)
Duration of effectiveness of method (years) Price**
Capacity (# of 90 kg bags)
Drying 50 1 4.5 0.28
Tarpaulin 50 5 6,2000 4000
Postharvest intervention *69 2 *61 5.00
Plastic Silos S 60 10 4,600 3.00
Plastic containers M 60 10 11,132 12.00
Plastic containers L 60 10 17,020 20.00
Metal Silos Small 60 20 8667 3.00
Metal Silos Medium 60 20 17833 12.00
Metal Silo Large 60 20 24883 20.00
* from Turner et al, rest from expert elicitation, ** from CIMMYT survey/ ACDI/VOCA
Present value of reduction in aflatoxin prevalence
Cost per bag of maize (Ksh/90 kg)
Cost per unit of reduction in risk (Cost-effectiveness)
Drying 50.00 16.07 0.32
Tarpaulin 226.22 155.00 0.69 Postharvest intervention 134.55 12.20 0.09
Plastic Silos S 481.52 1533.33 3.18
Plastic containers M 481.52 927.67 1.93
Plastic containers L 481.52 851.00 1.77
Metal Silos Small 769.82 2889.00 3.75
Metal Silos Medium 769.82 1486.08 1.93
Metal Silo Large 769.82 1244.15 1.62
Biocontrols 60.00 369.34 6.16
0
100
200
300
400
500
600
700
800
900
0 500 1000 1500 2000 2500 3000 3500
Pre
sen
t va
lue
of
red
uct
ion
in a
fla
tox
in
pre
vale
nce
Cost per bag of maize (Ksh/90 kg)
D
Tarp
Metal silos
Biocontrols
Plastic Silos
Post harvest
Drying
Technologies with similar costs and effectiveness Keeping everything else equal, technologies that abate the greatest risks
should be adopted first.
Technologies with similar costs and contamination risks Keeping everything else equal, more effective technologies should be
adopted first.
Technologies with similar effectiveness and contamination risks Keeping everything else equal, cheaper technologies should be adopted
first.
Technologies with differing levels of effectiveness and exhibit economies of scale properties Education efforts need to be directed at getting small holders to adopt
those measures most cost-effective for them; subsidies may be needed.
Governments may chose to intervene when the conditions required to achieve market efficient disease control outcomes through the use of subsidies.
From a public policy point of view, the key challenge is to identify the optimal subsidy or varying subsidies to achieve the greatest net social gain, which should be driven by and understanding of the cost effectiveness associated with a singular or combination of risk reduction activities.
WTP analysis suggest which technologies need subsidies;.
Difficult to identify the level of effectiveness in real world situation; relying on the experts;
Levels of effectiveness assume correct application of methods;
Estimates for cost of risk reduction technologies still in development highly uncertain;
Cross-contamination and further growth can occur further up the value chain; need to evaluate the cost/effectiveness of applicable interventions
Small-scale farmers (< 3
acres )
Producers
Agro-input shop
Town market
International NGOs
Extension services
Large-scale
farmers (> 3 acres)
Input providers
COLLECTORS
Large buyers at market
Large scale traders (incl
NCPB)
Traders
Small local informal traders
Aflatoxin risk at
storage
Aflatoxin risk at
transportation
Industrial processors
Aflatoxin risk at
transportation
Local Markets
Export (Sudan,
Somalia)
Supermarkets
Distributors/Consumers
Schools, hospitals, & other
institutions
Urban markets
Aflatoxin risk at
storage
Aflatoxin risk at
storage
Application point Procedure
Trader/WH/Processor Awareness building
Trader/WH/Processor Monitor mycotoxin levels in stores, remove damage corn, promote
the dry corn to optimal moisture content before storage
WH/storage Frequent cleaning of feed delivery systems and short-term storage
areas; drying techniques to achieve adequate storage moisture and
store product on dry clean surface, promote appropriate storage
structures for different size producers, and monitor for pest,
moisture levels
WH/storage/ Processor Separation of damaged and mould-infested kernels, (can be done
by one or a combination of several methods (farmer selection, belt
separator, gravity table, colour sorting, use of BGYF light)
Processor Enterosorption – based on the approach of adding a binding agent
to prevent the absorption of the toxin while the food is in the
digestive tract; Chemical inactivation by ammonization,
Nixtamalization with addition of hydrogen peroxide and sodium
bicarbonate, Thermal processing