Comparing modelled to measured mortality reductions: Applying the Lives Saved Tool to evaluation data from the Accelerated Child Survival Programme in West Africa

Elizabeth Hazel, Kate Gilroy, Ingrid Friberg, Robert E Black, Jennifer Bryce, Gareth Jones

Research output: Contribution to journalArticle

Abstract

Background: The Lives Saved Tool (LiST) projects the magnitude of mortality reduction based on baseline coverage, demographic characteristics and coverage targets. As a validation exercise, we compared neonatal, post-neonatal, infant, child and under-5 mortality reductions as projected by LiST to changes in mortality measured through demographic surveys in Ghana and Mali as part of a recently completed, retrospective evaluation of a child survival programme. Methods: Using coverage and other information collected during the evaluation, we modelled the predicted mortality reduction, using logical assumptions to fill gaps if no data were available. We performed a sensitivity analysis on several indicators for which we used a proxy, using the results to examine model sensitivity and readdress our assumptions. Results: In Ghana, the modelled mortality reductions were within the 95% confidence boundaries of the measured reduction. In Mali LiST significantly underestimated the reduction. Several coverage indicators were found to influence the projection, specifically case management of serious neonatal illness in both countries and pneumonia treatment, vitamin A measles treatment and breastfeeding promotion in Mali. Conclusions: We consider LiST to be a useful tool given the limitations of the available data. Although the model was a good match in Ghana, we identified several limiting factors with the input data in the Mali projection. This exercise highlights the importance of continually improving the availability of sound demographic, epidemiological and intervention coverage data at district and national levels. More comparative studies are needed to fully assess the strengths and weaknesses of LiST.

Original languageEnglish (US)
JournalInternational Journal of Epidemiology
Volume39
Issue numberSUPPL. 1
DOIs
StatePublished - Apr 1 2010

Fingerprint

Western Africa
Mali
Ghana
Mortality
Demography
Exercise
Measles
Case Management
Proxy
Breast Feeding
Vitamin A
Pneumonia
Therapeutics

Keywords

  • Accelerated child survival and development
  • Child health
  • Evaluation
  • Ghana
  • Lives saved tool
  • Mali
  • Mortality

ASJC Scopus subject areas

  • Epidemiology

Cite this

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title = "Comparing modelled to measured mortality reductions: Applying the Lives Saved Tool to evaluation data from the Accelerated Child Survival Programme in West Africa",
abstract = "Background: The Lives Saved Tool (LiST) projects the magnitude of mortality reduction based on baseline coverage, demographic characteristics and coverage targets. As a validation exercise, we compared neonatal, post-neonatal, infant, child and under-5 mortality reductions as projected by LiST to changes in mortality measured through demographic surveys in Ghana and Mali as part of a recently completed, retrospective evaluation of a child survival programme. Methods: Using coverage and other information collected during the evaluation, we modelled the predicted mortality reduction, using logical assumptions to fill gaps if no data were available. We performed a sensitivity analysis on several indicators for which we used a proxy, using the results to examine model sensitivity and readdress our assumptions. Results: In Ghana, the modelled mortality reductions were within the 95{\%} confidence boundaries of the measured reduction. In Mali LiST significantly underestimated the reduction. Several coverage indicators were found to influence the projection, specifically case management of serious neonatal illness in both countries and pneumonia treatment, vitamin A measles treatment and breastfeeding promotion in Mali. Conclusions: We consider LiST to be a useful tool given the limitations of the available data. Although the model was a good match in Ghana, we identified several limiting factors with the input data in the Mali projection. This exercise highlights the importance of continually improving the availability of sound demographic, epidemiological and intervention coverage data at district and national levels. More comparative studies are needed to fully assess the strengths and weaknesses of LiST.",
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AU - Jones, Gareth

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