List Analysis Projects

LiST ANALYSIS PROJECT: Interventions to reduce mortality in Ethiopia

Question:

Estimate the impact of scaling up a package of interventions (with or without scaling up the contraceptive prevalence rate, and with or without IPTprecommendation) impact on neonatal, U5, maternal mortality rate, rate of stillbirths, U5 deaths and lives saved in Ethiopia

Packages/Interventions of interest:

See table on next page.

Target values:

Time frame: Base year of coverage 2010, Target year of coverage 2015

Baseline coverage and scale up values were provided and based on Ethiopia’s Health Sector Development Plan IV

LiST Version Used:

Version 4.34 beta 3

Outputs of Interest:

Neonatal mortality rate

U5 mortality rate

Maternal mortality rate

Rate of stillbirths

Number of U5 deaths

Number of U5 lives saved

Baseline Coverage Values:

Population trendis obtained from the The2008 Revisionof theWorld Population Prospects published by the Population Division of the United Nations Department of Economic and Social Affairs of the United Nations Secretariat.

Child mortality estimates are obtained from The estimates from year 2008.5 were used.

Causes of death in children under 5 are obtained from the following article

  • Black, Robert E , Simon Cousens, Hope L Johnson, Joy E Lawn, Igor Rudan, Diego G Bassani, PrabhatJha, Harry Campbell, Christa Fischer Walker, Richard Cibulskis, Thomas Eisele, Li Liu, Colin Mathers, for the Child Health Epidemiology Reference Group of WHO and UNICEF (2010).Global, regional, and national causes of child mortality in 2008: a systematic analysis.Lancet. 375 (9730): 1969 - 1987.

Coverage values for interventions were obtained from Ethiopia’s Health Sector Development Plan IV

LiST Intervention / Indicator Used (from Ethiopia’s HSDP IV) / Baseline (%) / Target (2015)
ANC / 4+ Visits / Focused antenatal care coverage / 31 / 86
IPTp / 2 doses SP or sleeping under an ITN [Proportion of pregnant women who slept under LLIN the previous night] / 41.2 / 86
Tetanus Toxoid / 2+ doses / Focused antenatal care coverage / 31 / 86
Multiple micronutrient supplementation / Proportion of pregnant women supplemented with iron during pregnancy / 10 / 86
Clean practices/ essential newborn care / Proportion of HCs with available B-EmONC services / 5 / 100 (62)
Neonatal resuscitation / Proportion of asphyxiated newborns who are resuscitated [this may include hospitals which is not what we want. We only want health center and below for coverage] / 7 / 75
PMTCT / Proportion of pregnant women who receive ANC at PMTCT site who receive testing for HIV / 16 / 83
Postnatal care service coverage / Postnatal care coverage / 34 / 78
Exclusive breast feeding / Proportion of children 0-6 months exclusively BF / 49 / 70
Complementary feeding / Proportion of children 6-9 months receiving complementary food and continued breastfeeding / 54 / 65
ITN/IRS / Proportion of children under 5 sleeping under LLIN the previous night / 42.5 / 86
Latrine coverage / Proportion of households with latrine / 60 / 93
DPT3 coverage / PENTA coverage / 82 / 96
Measles coverage / 77 / 90
Zinc for diarrhea management / [No GOE target for this] / 0 / 25
Family Planning – Contraceptive Prevalence Rate / CPR / 32 / 66
Facility Based Birth / Proportion of deliveries attended by a skilled health attendant [Note, we want BEmOC interventions, not CEmOC because we only want services at Health Center level, not hospital level] / 18.4 / 62
Skilled birth attendant (HEWs) / Proportion of deliveries attended by a Health Extension Worker (HEW) / 11 / 38
Vitamin A / Percentage of children aged 6-59 months who received at least two doses of Vitamin-A in the last 12 months / 94 / 96
Rotavirus coverage / 0 / 90
Pneumococcal coverage / 0 / 90
Case management of pneumonia (oral antibiotics) / Proportion of under five children with pneumonia who received antibiotics at community level by HEWs / 0 (4.9) / 41 (45.9)
ORS / Proportion of under five children with diarrhea who received ORT / 37 / 89
Antimalarials / Proportion of U5 children diagnosed & treated for malaria / 32 / 82
Improved water source / Increase proportion of households using HH water treatment and safe storage practices / 7 / 77
Improved excreta disposal / Proportion of villages free of open defecation / 15 / 20

Results:

With IPTp recommendation, more than 687,400 U5 lives are saved with CPR scaled up, and more than 475,300 U5 lives are saved without CPR scaled up. When IPTp is not recommended, more than 687,100 U5 lives are saved with CPR scaled up, while more than 474,900 U5 lives are saved.