Prioritizing Child Health Care in Ethiopia: Modeling Impact on Child Mortality, Life Expectancy and Inequality in Age At Death with the Lives Saved Tool (LiST)

Prioritizing Child Health Care in Ethiopia: Modeling Impact on Child Mortality, Life Expectancy and Inequality in Age At Death with the Lives Saved Tool (LiST)

Background: Knowledge of effective interventions to reduce child mortality exists, but decision makers lack contextualized information to inform explicit priority setting in resource-constrained settings. The aim of this study is to estimate the potential impact of increasing coverage of 14 selected health care interventions on child mortality, life expectancy and inequality in the age of death (Ginihealth) in Ethiopia. 

Material and methods: We estimate the potential impact of scaling-up child health interventions from 2011 to 2015 by use of the Lives Saved Tool (LiST) and the newest available data on coverage, epidemiology and evidence-based effectiveness data. Scenario 1 consists of a health care package of 14 interventions scaled-up to target coverage levels specified in the Ethiopian Health Sector Development Program IV. Scenario 2 consists of 14 interventions scaled-up to 90 % coverage. Scenario 3 consists of the five most impacting interventions (from scenario 2) scaled-up to 90% coverage.

Results**: Scenario 1, 2 and 3 estimate that respectively 32 %, 58 % and 44 % of all child deaths could be averted. Under-five mortality rate could be reduced to 69.1, 43.0 and 56.7 per 1000 live births. Life expectancy would increase to 62.5 (+2.0), 64.2 (+3.7) and 63.4 (+2.9) years and Ginihealth would be reduced to 0.21 (-0.03), 0.18 (-0.06) and 0.19 (-0.05).

Conclusions: The Millennium Development Goal 4 aiming at a 2/3 reduction in under-five mortality rate (below 68 deaths per 1000 live births) is achievable. Increased coverage of high-impact child health interventions should be prioritized because this will also increase life expectancy and reduce inequality in the age of death in the Ethiopian population.

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**preliminary results