|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, and Gareth Jones
||International Journal of Epidemiology, 2010 April; 39(suppl_1): i32–i39.
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.
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.
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.
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.
Child health, lives saved tool, mortality, evaluation, Ghana, Mali, accelerated child survival and development