The document summarizes the findings of a Lives Saved Tool (LiST) analysis conducted in Ethiopia. It describes: 1) An overview of LiST, how it models the impact of scaling up interventions on child mortality. 2) The modeling of 3 scenarios - if interventions remained at 2000 levels, were scaled up from 2000-2005, and from 2000-2011. 3) The major findings - over 100,000 additional child deaths were averted by scaling up interventions from 2000-2011, with over 50% of lives saved due to reducing undernutrition and 23% from immunizations.

1. CD Partners’ meeting
December 03, 2014
Harmony Hotel,
Addis Ababa
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Ethiopian Case study
Lives Saved Tool (LiST) Analysis

2. Outline
 An overview of LiST
 Steps in modeling LiST
 Major Findings
 Conclusion & Recommendation
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3. An overview of LiST
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Lives Saved Tool (LiST) is a modular computer program,
in Spectrum software, used to estimate the impact of
scaling up interventions on mortality (Stover et al, 2010)
LiST uses country-specific baseline information on:
mortality rates, background variables across continuum of
care, and coverage of key interventions to construct a
model
LiST uses estimates of the effects of interventions on
cause-specific child mortality as a basis for generating
projections of child lives saved by increasing coverage of
effective interventions.

4. An overview……
 LiST is used to estimate:
1.No. of additional deaths averted or child
lives saved within the reference period
(2000-2011).
2.The relative contributions of major high
impact interventions within the health that
helped for reduction of child mortality.
3.Under-five mortality rates and trends
across the developed scenarios.
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5. Steps in modeling LiST:
Analytical framework
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High Impact
Interventions (HEP)
1.Maternal health Interventions
Balanced energy supplementation,
ANC1+, ANC4+ , SBA,TT2+, PNC
2. Child health interventions
IMNCI /ICCM, Measles,
ORS, DPT3 , (Hib) ,
Case seeking of pneumonia,
pneumococcal , etc
3. Nutritional Intervention
EOS, CBN, PSNP, AGP
Breast feeding, VAS,
Supplementary feeding
(reducing stunting and wasting )
4. WASH interventions
Access to improved H2O
Improved sanitation
ITN/IRS
Hygienic disposal of
children stool
Child Lives
Saved

6.  To estimate the additional deaths averted,
relative contributions of high impact
interventions and U5MRs from 2000-2011,
three scenarios were modeled.
 The year 2000 was taken as baseline year
 The year 2005 was taken as focus year
 The year 2011 was taken as final year.
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Steps….. Modeling Scenarios

7. Steps:Modeling …..
The three scenarios are:
 Scenario-1: Model for estimating the number of deaths
averted among children under-five by 2011 if all interventions
are similar to their baseline year values in 2000.
 Scenario-2: Model for estimating the number of deaths
averted among children under-five by 2011 if all interventions
are scaled up from 2000-2005 relative to their baseline values
in 2000.
 Scenario-3: Model for estimating the number of deaths
averted among children under-five by 2011 if all interventions
are scaled up from 2000-2011 relative to their baseline values
in 2000.
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8. Major findings:
Additional Deaths averted
 Approximately 27,000 child deaths would have been averted in
2011 if the interventions coverage were unchanged after 2005,
 More than 101,000 child deaths were averted among children
under-five in 2011 through scaling up of all available interventions
from 2000 to 2011 relative to baseline year.
 Out of these, more than 74,000 child deaths were averted in
2011 as a result of activities implemented during 2005 to
2011.
 Totally about 469,000 child lives were saved by the various
interventions between 2000 and 2011
 Out of these, nearly 103, 000 deaths were averted in 2011 alone as
result of various interventions between 2000 and 2011.
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9. Major findigs…
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Year Scenario 1 (baseline year 2000) Scenario 2 (2000-2005) Scenario 3 (2000-2011)
2000 145.6 145.6 145.6
2005 144.7 136.5 136.5
2011 142.2 133.3 108.0
Percent of decline 2 8
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Annual rate of decline 0.2 0.8
2.3
U5MR estimates

10. Major Findings….
U5MR estimate
 U5MRs estimated by LiST are higher than IGME
estimates except in the baseline year (145.6/1000 LBs)
 Percent decline in U5MR for 2000-2011 is 26% and 51%
by LiSTand IGME, respectively.
 The percent decline estimated by LiST for 2005-2011 is
21% whereas the percent decline by IGME is 35%.
 The percent decline explained by LiST relative to
IGME for the periods 2000-2005 and 2005-2011 is
25% and 60%, respectively.
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11.  LiST estimates were subjected to 3 limitations:
1. LiST can only estimate U5MRs based on available
measured values of interventions within the health
sector that have a rigorous evidence-base.
2. There were many data not included, and the fact that
LiST typically resulted in conservative estimates with
the interventions used in the model.
3. The model did not account for all indirect effects of
family planning practices and other socio-economic
status of parents on U5MR reduction
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U5MR estimate….
LiST Annex

12. Major findings….
Trends of U5MR estimates
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13. 13
Major findings…
Relative contributions of high impact interventions

14. Major findings…
Relative contributions of high impact interventions
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15. Relative contribution of High impact
interventions (2000-2011)
 Reduction in under-nutrition(stunting &
wasting) averted 50% of 469,000 child
deaths
 Scale-up of immunization (vaccines:
measles, DPT3, Hib) averted 23% of
469,000 child deaths
 Oral rehydration salts for diarrhea and
improved water averted 15% of 469,000
child deaths in 2000-2011
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16. Conclusions & Recommendation
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 The LiST estimate has shown a rapid
percent decline in U5MR for the period
2005-2011; nearly four-times higher than in
2000-2005.
 Among many reasons that can explain this
difference, implementation of HEP can be
taken as example.
 Thus, innovation of programs like HEP shall
be encouraged in the developing country.

17.  LiST finding showed that stunting and other forms
of under-nutrition are clearly the major contributing
factors to child mortality.
 Reduction in under-nutrition is the result of
combined activities in different health and non-
health system related factors.
 Thus, Multi-sectoral Networking & Partnership
should be encouraged in reducing under-nutrition.
 And hence, Gov’t shall give outstanding attention
on interventions that help to reduce under-nutrition
for further reduction in child mortality.
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Conclusions & Recommendation

18.  Preventive vaccines have shown relatively
high contribution in saving child lives.
 Thus, due attention shall be given to routine
child immunization and campaigns so as to
reduce child mortality.
 Treatment to sick children, for instance
provision of ORS has shown significant role
in saving child live.
 Therefore, awareness creation for community
on care seeking behavior shall be given
special attention.
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Conclusions & Recommendation

19. Thank you!
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