As a public health burden, severe acute malnutrition (SAM) among children has been increasingly studied to determine the optimal combination of treatment approaches. Among the new approaches is the addition of early childhood development sessions to standard nutrition-based treatment for SAM which can enhance both nutrition and development outcomes among young children. However, few studies demonstrate the relationship between the costs of such combined programs and the benefits accrued to the children and their caregivers. This article describes our experience of designing and conducting an economic evaluation alongside a cluster randomized controlled trial assessing a combined nutrition and psychosocial intervention for the treatment of SAM in children aged 6–24 months in Nepal. We present key lessons learned regarding methodological choices, the challenges of field data collection, as well as study adjustment when data analysis did not unfold as anticipated. With the view to transparency, this manuscript provides some clarifications on the evaluation processes for funders and policy makers on what economic evaluations entails and what information they convey for the purpose of supporting policy decision-making around limited resource allocation.

作为一种公共卫生负担，儿童严重急性营养不良（SAM）已得到越来越多的研究，以确定治疗方法的最佳组合。新方法之一是在 SAM 标准营养治疗的基础上增加儿童早期发育课程，这可以增强幼儿的营养和发育成果。然而，很少有研究证明此类联合计划的成本与儿童及其照顾者所获得的收益之间的关系。本文介绍了我们设计和进行经济评估以及整群随机对照试验的经验，该试验评估了尼泊尔 6-24 个月大儿童 SAM 的联合营养和社会心理干预治疗。我们提出了有关方法选择、现场数据收集的挑战以及数据分析未按预期展开时的研究调整方面的重要经验教训。出于透明度的考虑，本手稿对资助者和政策制定者的评估流程进行了一些澄清，说明经济评估需要哪些内容以及它们传达哪些信息，以支持围绕有限资源分配的政策决策。