List Analysis Projects

LiST ANALYSIS PROJECT: MNCH interventions for advocacy

Question:

What would the impact be on maternal, neonatal and child mortality if proven interventions were scaled up or if new interventions were introduced in the 68 priority countdown countries?

Packages/Interventions of interest:

Each intervention was scaled up individually, thus the impacts are not packaged. If they were packaged together, the lives saved would be smaller.

Proven interventions Targets

Target coverage
SBA/Facility Delivery* / 60%
BEmONC / 60%
CEmONC / 60%
Postnatal Visit / 80%
Exclusive breastfeeding (<6 months) / 80%
Clean water / improved sanitation** / 80%
ITN/IRS / 80%
Hib Vaccine / 80%
ORS+Zinc / 80%
Treatment for pneumonia / 80%
Treatment for malaria / 80%

Note that interventions with high coverage must be maintained in order to ensure that additional lives are not lost (i.e. TT, DPT3, Measles vaccine and Vitamin A supplementation)

* includes some increase in antenatal corticosteroids and antibiotics for pPRoM as well as some increase in both basics emergency obstetric care and comprehensive emergency obstetric care.

** assumes only increases in improved water, not increased availability of piped water in the home.

New interventions Targets

Target Coverage
Active management of the third stage of labor / 60%
MgSO4 (for pre-eclampsia) / 60%
Neonatal resuscitation / 60%
Kangaroo mother care / 60%
Injectible antibiotics for neonatal infections / 80%
Rotavirus vaccine / 80%
Pneumococcal vaccine / 80%
Zinc supplementation / 80%
Hand washing / 80%

LiST Version Used:

Version 4.0

Outputs of Interest:

The outputs of interest were the percent reductions in the number of maternal deaths, neonatal deaths and under-5 deaths.

Baseline Coverage Values

(Available for download along with the relevant projection files)

Results:

Improvement in coverage of several of the proven interventions can still have a large impact on mortality. For children, increased coverage of exclusive breastfeeding to 80% for children less than 6 months of age could reduce under-5 mortality by approximately 13% while if ORS and zinc were similarly rolled out in the 68 priority countries, an 11% reduction in under-five mortality could be achieved. For neonates, the single intervention which could have the greatest impact would be Comprehensive emergency obstetric and neonatal care (at 60% coverage), reducing neonatal mortality by 16%. This would also avert 42% of maternal deaths.

Among ‘new’ interventions, neonatal resuscitation, injectible antibiotics for severe neonatal infection and hand-washing could also reduce mortality by a significant amount.