What is the John Hopkins LiST tool
The Lives Saved Tool (LiST) – developed by the Institute for International Programs at Johns Hopkins Bloomberg School of Public Health and funded by the Bill & Melinda Gates Foundation – is a tool which estimates the impact of scaling up on maternal, newborn, and child health, and nutrition (MNCH&N) interventions. LiST is housed within Spectrum, a software package maintained by Avenir Health. Users – including NGOs, government partners, researchers, project planners and graduate students – have been using the model for over 10 years. The LiST team regularly updates the model to incorporate the most recent evidence available from the scientific literature and household survey data, ensuring that results are as recent and accurate as possible.
LiST calculates changes in cause-specific mortality based on intervention coverage change, intervention effectiveness for that cause, and the percentage of cause-specific mortality sensitive to that intervention. Default coverage data comes from large scale validated surveys – typically Demographic and Health Surveys (DHS), Multiple Indicator Cluster Surveys (MICS) and WHO/UNICEF Joint Monitoring Program. Default effectiveness values come from systematic reviews, meta-analyses, Delphi estimations, and randomized control trials. Affected fractions are built using data from the Child Health Epidemiology Reference Group (CHERG) and the UN Inter-agency Group for Child Mortality Estimation (IGME). These high quality data sources as inputs translate into estimates that can be trusted. Additionally, users who have more recent or better data can easily replace default data with their own.
How does LiST calculate lives saved in the 1000 Day Journey project
1000 Day Journey program evaluators collected data at the baseline of the project and after one year of implementation. Using the LiSt tool, an analysis was conducted using data from the five countries where the 1000 Day Journey project is in operation – Bangladesh, Kenya, Myanmar, Pakistan and Tanzania. To analyze the number of lives saved through project implementation, evaluators matched and analyzed the following indicators:
- Early initiation of breastfeeding;
- Exclusive breastfeeding <1-5 months;
- Skilled birth attendance at childbirth;
- Complementary feeding for children;
- Postnatal care practices;
- Iron supplementation for pregnant women; and
- Handwashing with soap
How was the LiSt analysis conducted
The LiST analysis was conducted in three phases:
- Phase 1– This phase consisted of collecting population level data at the regional or provincial level for each of the project countries from various data sources including; Demographic and Health Survey (DHS), recent country Census data and data from the Ministry of Health. The purpose of this phase is to ensure that LiST information accurately reflects the experience of local populations.
- Phase 2 – Once the baseline had been established, the baseline and outcome monitoring data for the seven indicators was inputted into the LiST model for analysis.
- Phase 3- The LiST analysis was conducted to generate an estimation of the number of deaths prevented because of the seven identified indicators. The estimation of the number of deaths averted is equal to the difference between no-projection (no coverage change due to any intervention) and projection with ENRICH data (coverage with ENRICH data).
*Reports offer a cumulative representation of the 1000 Day Journey initiative to date