Progress in Reducing Child Mortality and Undernutrition in India: An Application of the Lives Saved Tool
30 Pages Posted: 17 Sep 2018More...
Background: The Lives Saved Tool (LiST) has been used to estimate the impact of scaling up intervention coverage on undernutrition and mortality. Evidence for the model is largely based on efficacy trials raising concerns of applicability to large-scale contexts. We modeled the impact of scaling up health programs in India between 2006 and 2016 and compared estimates to observed changes.
Methods: Demographics, intervention coverage, and nutritional status were obtained from National Family and Health Survey 2005-2006 (NFHS-3) for the base year and NHFS-4 2015-2016 for endline. We used the LiST to estimate the impact of changes in coverage of interventions over this decade on child mortality and undernutrition at national and subnational levels and calculated the gap between estimated and observed changes in 2016.
Findings: At the national level, LiST estimates are close to the actual values of mortality for children <1y and <5y in 2016 (at 41 vs 42·6 and 50 vs. 56·4, respectively, per 1000 live births). National estimates for stunting, wasting and anemia at are also close to the actual values of NFHS-4. At the state level, actual changes were higher than the changes from LiST projections for both mortality and stunting. The predicted changes using the LiST ranged from 33% to 92% of the actual change.
Interpretation: The LiST provided national projections close to, albeit slightly below, actual performance over a decade. Reasons for poorer performance of state-specific projections are unknown; further refinements to the LiST for subnational use would improve the usefulness of the tool.
Funding Statement: Bill & Melinda Gates Foundation through Partnerships and Opportunities to Strengthen and Harmonize Actions for Nutrition in India (POSHAN), led by International Food Policy Research Institute.
Declaration of Interests: Authors declare no conflicts of interest.
Keywords: India; Lives Saved Tool; Child Mortality; Stunting; Undernutrition
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