Using the Lives Saved Tool to aid country planning in meeting mortality targets: a case study from Mali

Abstract

Background: Mali is one of four countries implementing a National Evaluation Platform (NEP) to build local capacity to answer evaluation questions for maternal, newborn, child health and nutrition (MNCH&N). In 2014-15, NEP-Mali addressed questions about the potential impact of Mali's MNCH&N plans and strategies, and identified priority interventions to achieve targeted mortality reductions. Methods: The NEP-Mali team modeled the potential impact of three intervention packages in the Lives Saved Tool (LiST) from 2014 to 2023. One projection included the interventions and targets from Mali's ten-year health strategy (PDDSS) for 2014-2023, and two others modeled intervention packages that included scale up of antenatal, intrapartum, and curative interventions, as well as reductions in stunting and wasting. We modeled the change in maternal, newborn and under-five mortality rates under these three projections, as well as the number of lives saved, overall and by intervention. Results: If Mali were to achieve the MNCH&N coverage targets from its health strategy, under-5 mortality would be reduced from 121 per 1000 live births to 93 per 1000, far from the target of 69 deaths per 1000. Projections 1 and 2 produced estimated mortality reductions from 121 deaths per 1000 to 70 and 68 deaths per 1000, respectively. With respect to neonatal mortality, the mortality rate would be reduced from 39 to 32 deaths per 1000 live births under the current health strategy, and to 25 per 1000 under projections 1 and 2. Conclusions: This study revealed that achieving the coverage targets for the MNCH&N interventions in the 2014-23 PDDSS would likely not allow Mali to achieve its mortality targets. The NEP-Mali team was able to identify two packages of MNCH&N interventions (and targets) that achieved under-5 and neonatal mortality rates at, or very near, the PDDSS targets. The Malian Ministry of Health and Public Hygiene is using these results to revise its plans and strategies.

Are there decision support tools that might strengthen the health system for perinatal care in South African district hospitals? A review of the literature

“…LiST cannot be used to estimate the impact of interventions on perinatal mortality solely, since the assessment of the impact of interventions is limited to the predefined age intervals which do not cover the perinatal period exclusively [26]. LiST has been useful in strategic planning and in identifying interventions that would have highest impact in saving lives and has been applied in LMIC at national, provincial and district levels [9, 47, 50, 56–58, 69].…”

Factors contributing to neonatal mortality reduction in three regions in Ghana: a mixed-methods study using the Lives Saved (LiST) modelling tool

“…In addition, most of the LiST analysis focused on sub-Saharan Africa countries have concentrated on forecast models of under-5 mortality broadly. [38][39][40][41][42] Moreover, many studies do not disaggregate the neonatal period from the post neonatal period, [38][39][40][41][42] nor have they explored factors responsible for historical declines in neonatal mortality in different contexts. [43][44][45][46] In a forecast LiST analysis in the KwaZulu-Natal province of South Africa, McGee et al found that improved labor and delivery management would save the most newborn lives over a 15-year period, compared to other interventions.…”

Contribution of child health interventions to under-five mortality decline in Ghana: A modeling study using lives saved and missed opportunity tools

“…There were over 70 interventions in LiST at the global level as of 2011. The LiST has been validated and used in studies in several countries including Ghana [13][14][15][16][17][18][19]. It was used to model the number of lives saved and percent mortality rate reduction based on changes in intervention coverage levels and the decrease in the prevalence of stunting and wasting in this study [20][21][22][23].…”