Economic Evaluation: Costing participatory learning and action cycles with women's groups to improve feeding, care and dental hygiene for South Asian infants in London

Yeqing Zhang¹Priyanka Patil^2,3Shweta Chaudhary³Kunal D Kondhare⁴Darlington David Faijue³Monica Lakhanpaul^4,5Michelle Heys³Joanna Drazdzewska⁶Clare Heidi Llewellyn⁷Kelley Webb-Martin⁸Carol Irish⁸Mfon Archibong⁸Jenny Gilmour⁹Phoebe Kalungi⁹Jolene Skordis¹Logan Manikam^2,3*Neha Batura¹

• ¹Institute for Global Health, Faculty of Population Health Sciences, University College London, London, England, United Kingdom
• ²Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, Faculty of Population Health Sciences, University College London, London, England, United Kingdom
• ³Aceso Global Health Consultants, Singapore, Singapore
• ⁴Population, Policy and Practice Research and Teaching Department, Great Ormond Street Institute of Child Health, Faculty of Population Health Sciences, University College London, London, England, United Kingdom
• ⁵Collaborative Centre for Inclusion Health, London, United Kingdom
• ⁶Women and Children First, London, United Kingdom
• ⁷Department of Behavioural Science and Health, University College London, London, England, United Kingdom
• ⁸Children’s Health 0-19 Service, London Borough of Newham, London, United Kingdom
• ⁹Tower Hamlets GP Care Group, Mile End Hospital, London, United Kingdom

Background The Nurture Early for Optimal Nutrition (NEON) programme was designed to promote equitable early childhood development by educating mothers of South Asian origin in two boroughs (Newham and Tower Hamlets) in East London on optimal feeding, care, and dental hygiene practices. The study found that the adapted Participatory Learning and Action (PLA) approach was highly acceptable and well-received by participants, with improvements in maternal confidence, infant feeding practices, and community engagement. This study conducted a cost analysis of the NEON programme and evaluated its financial sustainability. Methods We conducted a financial and economic costing from the provider perspective. Estimates of total and average costs per mother are presented along with affordability assessments, expressed as a proportion of the borough's annual child development expenditure. All costs were discounted and reported in 2022 pound sterling and in 2022 international dollars. Results The total cost of NEON design and delivery was £68,165 ($INT 102,658), and the average cost per mother participating in the programme was £439($INT 661) in the face-to face arm and £407($INT 614) in the online arm. The largest contributor to the total cost was materials (50%), followed by staff costs (45%) and capital investments (5%). The total cost of intervention delivery in Newham accounted for around 0.047% of the borough’s annual child development expenditure, while the total intervention cost in Tower Hamlets was equivalent to 0.003% of its spending on children’s development. Conclusion The delivery of NEON is largely within local authorities’ budget for childhood development.