Estimated Economic Losses from Foodborne Diseases Cases Associated with the Free Nutritious Meal (MBG) Program in Indonesia

Estimated Economic Losses from Foodborne Diseases Cases Associated with the Free Nutritious Meal (MBG) Program in Indonesia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Estimated Economic Losses from Foodborne Diseases Cases Associated with the Free Nutritious Meal (MBG) Program in Indonesia Isnawati Hidayah, Media Wahyudi Askar, Aulia Lianasari, Bakhrul Fikri This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8247230/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract The Free Nutritious Meal Program (Makan Siang Gratis, MBG) has been imple- mented nationwide in Indonesia since January 2025 as one of the government’s flagship social interventions. However, between January and November 2025, a total of 15,117 foodborne diseases cases linked to MBG meals were recorded across Indonesia, raising concerns regarding food safety, program governance, and the unintended economic burden borne by households and the broader health system. This study employs the Cost of Illness (COI) framework to quantify the economic burden of MBG-related foodborne diseases. COI is a well-established method used to estimate the total direct medical costs, indirect productivity losses, and out of pocket (OOP) expenditures attributable to a disease or diseases. The approach assumes that the economic losses caused by diseases represent the potential economic benefits that could have been realized if the disease had been prevented. This study provides an evidence-based assessment of the total eco- nomic burden generated during MBG’s first year of implementation. This study finds the total societal loss becomes substantial, rising from USD 516,298 in the low scenario to USD 833,186 in the high scenario. The findings offer critical insights for policymakers regarding the cost-effectiveness, risk management, and sustainability of large-scale feeding programs in Indonesia. Health Economics & Outcomes Research Health Policy Free Nutritious Meal Program (MBG) COI Foodborne Diseases Full Text Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8247230","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":556424786,"identity":"141ed405-1982-45de-b59e-2b5c0ca9e4bc","order_by":0,"name":"Isnawati Hidayah","email":"data:image/png;base64,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","orcid":"https://orcid.org/0000-0002-4248-2234","institution":"Center of Economic and Law Studies (CELIOS)","correspondingAuthor":true,"prefix":"","firstName":"Isnawati","middleName":"","lastName":"Hidayah","suffix":""},{"id":556424787,"identity":"721105ec-140f-4533-a682-b71011a2a59c","order_by":1,"name":"Media Wahyudi Askar","email":"","orcid":"https://orcid.org/0000-0003-3635-0961","institution":"Center of Economic and Law Studies (CELIOS)","correspondingAuthor":false,"prefix":"","firstName":"Media","middleName":"Wahyudi","lastName":"Askar","suffix":""},{"id":556424789,"identity":"91e59a3f-cce2-4dc0-9c86-640263343d68","order_by":2,"name":"Aulia Lianasari","email":"","orcid":"","institution":"Center of Economic and Law Studies (CELIOS)","correspondingAuthor":false,"prefix":"","firstName":"Aulia","middleName":"","lastName":"Lianasari","suffix":""},{"id":556424788,"identity":"25bccbe8-5cad-47d7-b4f0-c0f881212212","order_by":3,"name":"Bakhrul Fikri","email":"","orcid":"","institution":"Center of Economic and Law Studies (CELIOS)","correspondingAuthor":false,"prefix":"","firstName":"Bakhrul","middleName":"","lastName":"Fikri","suffix":""}],"badges":[],"createdAt":"2025-12-01 07:27:39","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-8247230/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8247230/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":98622306,"identity":"ea4754cc-706f-49f9-aba2-fbe6e1af0c48","added_by":"auto","created_at":"2025-12-19 16:51:39","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":418691,"visible":true,"origin":"","legend":"","description":"","filename":"COIManuscriptFINAL.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8247230/v1_covered_cb768f7f-bc71-4ba0-b067-9c30d883bd84.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eEstimated Economic Losses from Foodborne Diseases Cases Associated with the Free Nutritious Meal (MBG) Program in Indonesia\u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":true,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Center of Economic and Law Studies (CELIOS)","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Free Nutritious Meal Program (MBG), COI, Foodborne Diseases","lastPublishedDoi":"10.21203/rs.3.rs-8247230/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8247230/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe Free Nutritious Meal Program (Makan Siang Gratis, MBG) has been imple- mented nationwide in Indonesia since January 2025 as one of the government’s flagship social interventions. 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