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 IPTp recommendation) 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 trend is obtained from the The 2008 Revision of the World Population Prospects published by the Population Division of the United Nations Department of Economic and Social Affairs of the United Nations Secretariat. http://esa.un.org/unpd/wpp2008/index.htm Child mortality estimates are obtained from http://www.childmortality.org. 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, Prabhat Jha, 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 ANC IPTp Tetanus Toxoid Multiple micronutrient supplementation Clean practices/ essential newborn care Neonatal resuscitation PMTCT Postnatal care service coverage Exclusive breast feeding Complementary feeding ITN/IRS Indicator Used (from Ethiopia’s HSDP IV) 4+ Visits / Focused antenatal care coverage 2 doses SP or sleeping under an ITN [Proportion of pregnant women who slept under LLIN the previous night] 2+ doses / Focused antenatal care coverage Proportion of pregnant women supplemented with iron during pregnancy Proportion of HCs with available BEmONC services 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] Proportion of pregnant women who receive ANC at PMTCT site who receive testing for HIV Postnatal care coverage Proportion of children 0-6 months exclusively BF Proportion of children 6-9 months receiving complementary food and continued breastfeeding Proportion of children under 5 sleeping under LLIN the previous night Baseline (%) Target (2015) 31 86 41.2 86 31 86 10 5 86 100 (62) 7 75 16 83 34 78 49 70 54 65 42.5 86 Latrine coverage Proportion of households with latrine 60 93 DPT3 coverage PENTA coverage 82 96 77 90 0 25 32 66 18.4 62 Proportion of deliveries attended by a Health Extension Worker (HEW) 11 38 Percentage of children aged 6-59 months who received at least two doses of Vitamin-A in the last 12 months 94 96 0 90 Measles coverage Zinc for diarrhea management Family Planning – Contraceptive Prevalence Rate Facility Based Birth Skilled birth attendant (HEWs) Vitamin A Rotavirus coverage [No GOE target for this] CPR 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] Pneumococcal coverage Case management of pneumonia (oral antibiotics) ORS Antimalarials Improved water source Improved excreta disposal 0 90 Proportion of under five children with pneumonia who received antibiotics at community level by HEWs 0 (4.9) Proportion of under five children with diarrhea who received ORT 37 89 32 82 7 77 15 20 Proportion of U5 children diagnosed & treated for malaria Increase proportion of households using HH water treatment and safe storage practices Proportion of villages free of open defecation 41 (45.9) 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.