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Lives Saved Analyses for Child Survival Projects: Basic How-To Use LiST - Debra Prosnitz, MPH; Rebecca Levine, MPH; James Ricca MD, MPH; and Ingrid Friberg, PhD
- 1. Lives Saved Analyses for Child Survival Projects: Basic How-To Use LiST Debra Prosnitz, MPH; Rebecca Levine, MPH; James Ricca MD, MPH; and Ingrid Friberg, PhD
- 5. EasyLiST
- 8. Choosing “First Year of Intervention Program” Time Cause of Death Data Coverage Data Scale up of interest (i.e. CI, ACSD) 2003
- 9. Choosing “Target Year of Coverage” Time Cause of Death Data Coverage Data Scale up of interest (i.e. CI, ACSD) Target or End-line Survey 2003
- 17. The bottom is the baseline The top is the scale up
- 20. Opening a Projection in Expert Mode
- 21. Child Survival Data Sheet Health Status, Mortality and Economic Status
- 25. Effectiveness
- 28. Configuration
- 30. Coverage
Editor's Notes
- We start by creating a demographic projection using the DemProj module within Spectrum which is the envelope program that LiST is built into. This uses the UN World Population Report information on gender specific population structure by age, life expectancy, fertility rates and migration rates. Once we have the population projection, then we need to add the country specific child survival data on the cause of death and the baseline intervention coverages to the model. At the same time, the general effectiveness data for each of the interventions is also loaded into the program. With just that little bit of information, we can start to use the Impact tool. However, to really use it to the best of its ability, you’ll want to edit the child survival data to encompass changes in intervention coverage since the baseline year. Once we have the changed data, we will want to display it. When you start the program, you tell the computer to make a new projection
- The trend projections are already populated with country-specific data. If there is a trend projection file for the country that you are working with, start with these files. You will need to extract and save all of these files somewhere you can remember – a location that you will be able to open them from.
- Once you have created the projection and clicked OK. Your screen will appear blank. Your projection has been saved, and is open, don’t worry! To edit the projection (change coverage/scale up interventions) go to Edit and select Lives Saved Tool (LiST)
- The start year is automatically the current year. To change the target year: Click “Configure Years.” From the baseline year to the first year of the intervention, LiST will assume that there are no changes Match the year of coverage data with the year of the cause of death data EasyLiST assumes that the baseline year is 2003 In configure, you can also change the years that you are interested in (for display only)
- The start year is automatically the current year. To change the target year: Click “Configure Years.” From the baseline year to the first year of the intervention, LiST will assume that there are no changes Match the year of coverage data with the year of the cause of death data EasyLiST assumes that the baseline year is 2003 In configure, you can also change the years that you are interested in (for display only)
- If you want to change the baseline values, you can go into the Expert module, change the baseline value and then come back into EasyLiST to scale it up. The target values here are based on the best possible changes (that Neff found) globally, in low-middle income countries, in DHS data, based on 6 year scale up of interventions. To scale up an intervention, check the “on/off” box. Once you have selected an intervention, you can change the targets. Then click “Recalculate” in the bottom left corner.
- Yellow cells: there is no default coverage data for this intervention. If this is 99.9 it is to prevent someone from scaling this intervention up to 100% and getting a huge impact. Grey cells: Subcomponents of an intervention. These cannot be changed in EasyLiST. i.e. ANC is assumed to have no impact, the subcomponents of ANC have impact Polio and BCG have no impact on U5 morality based on this coverage (because these are given to children >5) **Remember to SAVE!* Close, File, Save Projection. If you are changing projections for scale up: Transfer the scale up to Expert, then “Save As” and rename**
- Remember to SAVE! Close, File, Save Projection. If you are changing projections for scale up: Transfer the scale up to Expert, then “Save As” and rename (twice)
- There are 13 different indicators that can be displayed, and each indicator can be displayed in a variety of ways, including tables, bar graphs and pie graphs.
- The bottom right corner has a menu of different displays. Once this menu is open, you can scroll up and down within the menu to view the different displays.
- The bottom right corner has a menu of different displays. Once this menu is open, you can scroll up and down within the menu to view the different displays.
- Close the projection you are working with in EasyList. (“File”, “Close” or click on “Close” in the bottom left corner of the EasyList projection). Open the baseline projection or trend file that you want to work with. Once you have the baseline projection open, you can add the child survival data. “ Edit”, “Lives Saved Tool (LiST).” This time select “Expert.”
- The buttons you are most likely to use are the two green buttons (configuration and coverage) and the one blue button (health status, morality and economic status), which is where all the country specific data resides. Effectiveness is for interventions that directly effect mortality, as well as for the effectiveness of nutritional interventions as risk factors affecting morbidity and mortality. After having chosen the country, the country specific intervention coverage data, the country specific health status, mortality and economic status and the effectiveness data are all loaded into the projection. I am going to skip over the coverage data for right now and come back to it in a few minutes.
- You can click on the tabs at the top and make changes here if needed. Here you see the data in health status. We have entered the data on community wide vitamin A and zinc deficiency as well as exposure to the malaria parasite, but only the falciparum species. If you feel that this is in error, you can uncheck these boxes or change the default data within the program itself. You may want to check Economic Status on occasion, just to make sure that everything is flat lined.
- The Mortality tab includes the cause of death information, as well as the NMR, IMR and under-5 mortality rates in the baseline year. All of the information can be changed, but is the best available for the baseline year. The third tab, ‘Economic status’ only includes the percent of people living on less than a dollar a day. You should not change any of these pieces of information unless you are very certain that stronger data is available. Changing economic status has an effect on two interventions, because it changes the percentage of the women at risk, and who can benefits from these interventions: Balanced energy supplementation Complementary feeding, education and supplementation If you make any changes here, click on the source button in the bottom right hand side of the page and record all of your information. When you are finished, hit “OK” to return to the main “Child Survival” data sheet.
- Effect sizes are global, and are based on data from various Lancet series and expert working groups (i.e. MAWG for malaria). Changing effect sizes is not recommended.
- The effectiveness data sheets have some special characteristics. First, if you change anything, it shows up in red. Second, if you change something and can’t remember what it was, you can click on the cell and then click display default in the bottom left corner and a message box like this one will show up. You can either manually change this or click on restore defaults and all cells will revert to the default data.
- Align the base year of coverage with the year of cause of death data (2003).
- Here is the postnatal (preventive) section. The country specific data was placed in the year 2003 as we requested when we chose the base year of coverage on the country tab, and copied over for each following year, because the program assumes that no changes have occurred in the coverage values. One thing to note is the yellow box. When you first open the program, the yellow box indicates that this data is missing. No valid baseline data was available for that intervention. In some countries, this is minimal, but in other countries, it is found for several variables. Frequently you want to make changes to the data that you see, either because you have more data, better data or you know the trajectory that has been followed over several years.
- Editing demography may be a quicker and easier way to ensure that LiST analyses apply to your project area population. If you don’t edit demography in Spectrum/LiST, you can just multiply all outputs (lives saved) by the ratio of the project area population to the national population. After you edit population data, you may also want to edit International Migration. If the population is small, it may be best to set this to zero. If you want to multiply international migration data by the same ratio as the population data, you will need to copy this into excel, do the multiplication in excel, and copy and paste the edited international migration data back into LiST. For sub-national or project area populations, you may also want to change the TFR, but if you do so, check with a demographer first!
- Go to “Edit”, “Demography” and Select “Demographic data”
- There are three ways to make changes to the coverage values: Change values one by one, by clicking on each cell and entering the number. Duplicate: Enter the new value into the first cell. Select all the cells of interest including that first change. Then click duplicate and you will get the same values as the initial cell in all the cells. Interpolate: This is similar to the duplicate function, but it interpolates values. You will need to enter and highlight the baseline and endline values, and then select all values in between. Click interpolate.
- In this example, improved excreta disposal was increased from 45% in 2009 to 65% in 2011. This was inerpolated from 2009 – 2011, giving the value of 55% for 2010. After the end of the intervention (2011) the new coverage of 65% was duplicated for the future years. **Note: if scaling up improved water, use LiST indicator “use of improved water source within 30 minutes.”** The “piped in” sub-section is not double counting the improved water data. Once you’ve made these coverage changes, you are essentially done. Make sure to save these changes under a new file name! with ‘save projection as’ on the file menu.
- In addition to LiST, you can display changes in demography including births, deaths, and death by age.
- Display of under 5 mortality over time for the baseline projections and the scaled-up (intervention) projection
- Maternal deaths prevented by cause for the intervention projection (India ex.)
- Good input yields good output (trash in, trash out!) Sometimes you may want to combine things in ways that LiST does not currently allow for, but which may already be available in excel. It is very easy to copy everything from a table in LiST into excel. You simply more the mouse over the top left hand corner of the table until you get a small plus sign. The right click and you can copy everything you need. When you do this, you can also change the number of decimal places that you can see. So if you think that there will be a very small change, you can use this to check to make sure that everything is working properly.