Methods used in the Lives Saved Tool (LiST).

BACKGROUND: Choosing an optimum set of child health interventions for maximum mortality impact is important within resource poor policy environments. The Lives Saved Tool (LiST) is a computer model that estimates the mortality and stillbirth impact of scaling up proven maternal and child health interventions. This paper will describe the methods used to estimate the impact of scaling up interventions on neonatal and child mortality. MODEL STRUCTURE AND ASSUMPTIONS: LiST estimates mortality impact via five age bands 0 months, 1-5 months, 6-11 months, 12-23 months and 24 to 59 months. For each of these age bands reductions in cause specific mortality are estimated. Nutrition interventions can impact either nutritional statuses or directly impact mortality. In the former case, LiST acts as a cohort model where current nutritional statuses such as stunting impact the probability of stunting as the cohort ages. LiST links with a demographic projections model (DemProj) to estimate the deaths and deaths averted due to the reductions in mortality rates. USING LIST: LiST can be downloaded at http://www.jhsph.edu/dept/ih/IIP/list/ where simple instructions are available for installation. LiST includes default values for coverage and effectiveness for many less developed countries obtained from credible sources. CONCLUSIONS: The development of LiST is a continuing process. Via technical inputs from the Child Health Epidemiological Group, effectiveness values are updated, interventions are adopted and new features added.

Spectrum: a model platform for linking maternal and child survival interventions with AIDS, family planning and demographic projections.

BACKGROUND: LiST is implemented in Spectrum, a modular computer program designed to examine the impact of interventions on health outcomes. A typical LiST application uses three other modules in Spectrum addressing demography, family planning and HIV/AIDS. METHODS: The demographic module projects the population by single age and sex over time and uses LiST calculations of the mortality rates by age group to calculate the number of deaths. The family planning module uses the proximate determinants of fertility framework to calculate the effects of increasing contraceptive use on the total fertility rate and, thus, the number of births. The HIV/AIDS module calculates the consequences of HIV epidemic trends on child mortality and the effects of programs to prevent mother-to-child transmission of HIV, cotrimoxazole prophylaxis and anti-retroviral treatment on the number of AIDS deaths. RESULTS: These modules provide LiST with estimates of the number of children and number of deaths by single age as they are affected by changes in fertility through family planning and interventions to prevent the transmission of HIV or delay AIDS death. CONCLUSIONS: Integrating LiST within the existing Spectrum system of planning models expands the scope of LiST to include the effects of demographic change, family planning and HIV interventions.