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International Health

The Lives Saved Tool (LIST)
New improvements and new contributions to global health policy and programming

As the popularity of the Lives Saved Tool (LiST) continues to grow, the LiST research team is determined to keep it on the cutting-edge of global health research and analysis. LiST is a computer-based tool that allows users to set up and run multiple scenarios to look at the estimated impact of different maternal, child and neonatal intervention packages and coverage levels for their countries, states or districts. LiST is headquartered in the Department’s Institute for International Programs and is part of the Child Health Epidemiology Reference Group (CHERG).

Family Planning’s Effect on Mortality

Senior Scientist Neff Walker, LiST’s lead faculty, is spearheading a research initiative to evaluate the link between family planning and birth outcomes. While fewer pregnancies mean fewer births, it should also decrease the number of riskier births. For example, women who delay pregnancy and who space them further apart face a lower risk of encountering pregnancy complications. Therefore, this decrease in risky pregnancies should also decrease the rate of neonatal deaths, but the effect is not precisely understood. Dr. Walker and LiST hosted an expert meeting in April. The findings suggest that the key effects on mortality were prematurity and small for gestational age. “As neonatal deaths become a larger proportion of under-five mortality,” Dr. Walker explains, “it is increasingly important to better understand the pre-natal pathways leading to newborn mortality.”

New Publications and Data

The LiST team is currently working on plans to incorporate the latest causes of death data from colleagues in the CHERG. The global, regional and national data were recently published in The Lancet (Liu, et al. 2012).  LiST analyses also contributed this year to a major international call-to-action by over 40 leading organizations, including Hopkins, WHO and Save the Children. Born Too Soon: The Global Action Report on Preterm Birth used a LiST analysis to inform many of its policy and programming recommendations. 

VisualizerLiST Visualizer

As part of their training and capacity-building efforts, the team launched the beta version of the LiST Visualizer.  The Visualizer illustrates the relationships between maternal and child health interventions and health outcomes. It shows the causal linkages between over 90 interventions and 60 different outcomes, including mortality and risk factors. “The Visualizer helps me in my training sessions more than I thought it would.  By removing the overwhelming amounts of data in the model, the images simplify, while still reflecting LiST’s complexity,” explained Assistant Scientist Ingrid Friberg, one of the core members of the LiST team. 

New Analysis for Large-Scale Programs

Part of LiST’s mandate is to assist the global health community in its intervention planning strategies. The MCHIP program is a USAID-funded maternal, child and neonatal health program that implements programming in over 30 countries across the globe. Associate Scientist Linda Bartlett, who is also an MCHIP adviser, asked the LiST team to compare the relative benefits of community health workers (CHWs), midwives, and trained medical doctors in maternal and neonatal health interventions. The LiST team constructed complex costing and efficacy scenarios based on the skills each type of provider can perform. For instance, CHWs are trained to do resuscitation and clean delivery, whereas midwives can also perform basic emergency obstetric care. Their results will help one of USAID’s flagship programs decide how best to allocate its resources to save the most maternal and newborn lives. 

The latest version of LiST, as well as regularly updated training materials, are always available at the LiST Website.  The group’s research publications and latest version of the Visualizer are also posted and you can sign up for LiST email updates.

--May 2012, Brandon Howard