Effects of Multiple Micronutrient-Fortified Bouillon Cube on Morbidity in Children 2–5 Y and Women 15–49 Y in Northern Ghana: A Randomized Controlled Trial

impacts on dietary adequacy and lives saved differed by country and by MN, and were generally nonlinear.In Burkina Faso, the cost per WRA achieving folate adequacy at 20 g folic acid/g was $0.27, $0.17 at 60 g/g, and $0.18 at 120 g/g; for the same folic acid concentrations in Nigeria, cost per WRA achieving adequacy rose steadily from $0.16 (20 g/g) to $0.50 (120 g/g).In Senegal, the cost per child-life saved by a multi-fortified bouillon cube containing 10% of Codex NRV of vitamin A, folic acid, and zinc in 2.5g was $1,655 (Nigeria $613 and Burkina Faso $4,325); cost per childlife saved by cube delivering 83% of Codex NRV of the same MN was $3,766 (Nigeria $2,330 and Burkina Faso $1,219).Conclusions: Measures of cost-effectiveness of bouillon fortification programs depend on dietary intake patterns and policy choices regarding the numbers and amounts of fortificants included in premixes.Knowing levels of fortification at which marginal impacts become small could help inform program design.Program efficiency should be considered alongside program objectives, affordability, and sustainability, and technical and commercial viability.