Using the missed opportunity tool as an application of the Lives Saved Tool (LiST) for intervention prioritization

Tam, Yvonne; Pearson, Luwei

doi:10.1186/s12889-017-4736-3

Cited by 8 publications

(8 citation statements)

References 21 publications

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“…EmONC indicators were developed to identify key factors that can help to reduce maternal and perinatal mortality. Previous studies have highlighted the impact of EmONC to reduce maternal and perinatal deaths in high risk pregnancies 12, 13 . In general, the results of our baseline analysis show that facility conditions are poor and lack sufficient medicines and supplies.…”

Section: Discussionmentioning

confidence: 99%

Facility conditions, obstetric and neonatal care practices, and availability of emergency obstetric and neonatal care in 72 rural health facilities in the Democratic Republic of the Congo: A cross-sectional study

et al. 2019

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Background: Current facility conditions, obstetric and neonatal care practices, and availability of emergency obstetric and neonatal care (EmONC) were assessed in the Kwango and Kwilu provinces of the Democratic Republic of the Congo (DRC). Methods: This is an analysis of the baseline survey data from an ongoing clinical mentoring program among 72 rural health facilities in the DRC. Data collectors visited each of the facilities and collected data through a pre-programmed smartphone. Frequencies of selected indicators were calculated by province and facility type—general referral hospital (GRH) and primary health centers (HC). Results: Facility conditions varied across province and facility type. Maternity wards and delivery rooms were available in the highest frequency of rooms assessed (>95% of all facilities). Drinking water was available in 25.0% of all facilities; electricity was available in 49.2% of labor rooms and 67.6% of delivery rooms in all facilities. Antenatal, delivery, and postnatal care services were available but varied across facilities. While the proportion of blood pressure measured during antenatal care was high (94.9%), the antenatal screening rate for proteinuria was low (14.7%). The use of uterotonics immediately after birth was observed in high numbers across both provinces (94.4% in Kwango and 75.6% in Kwilu) and facility type (91.3% in GRH and 81.4% in HC). The provision of immediate postnatal care to mothers every 15 minutes was provided in less than 50% of all facilities. GRH facilities generally had higher frequencies of available equipment and more services available than HC. GRH facilities provided an average of 6 EmONC signal functions (range: 2-9). Conclusions: Despite poor facility conditions and a lack of supplies, GRH and HC facilities were able to provide EmONC care in rural DRC. These findings could guide the provision of essential needs to the health facilities for better delivery of maternal and neonatal care.

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Section: Discussionmentioning

confidence: 99%

Facility conditions, obstetric and neonatal care practices, and availability of emergency obstetric and neonatal care in 72 rural health facilities in the Democratic Republic of the Congo: A cross-sectional study

et al. 2019

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“…The analysis has change in coverage of lifesaving interventions as an endpoint, not mortality. While it is commonly understood that coverage is the essential penultimate step on the pathway towards improved survival [ 1 , 12 , 24 ] it provides less certainty than evidence of actual mortality impact. Analyses were conducted at the cluster level thus the ecological fallacy (potential mis-interpretation about the nature of individuals relative to the group to which those individuals belong) cannot be ruled out.…”

Section: Discussionmentioning

confidence: 99%

Associations between increased intervention coverage for mothers and newborns and the number and quality of contacts between families and health workers: An analysis of cluster level repeat cross sectional survey data in Ethiopia

et al. 2018

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BackgroundSurvival of mothers and newborns depends on life-saving interventions reaching those in need. Recent evidence suggests that indicators of contact with health services are poor proxies for measures of coverage of life saving care and attention has shifted towards the quality of care provided during contacts.Methods and findingsRegression analysis using data from representative cluster-based household surveys and surveys of the frontline health workers and primary health facilities in four regions of Ethiopia in 2012 and 2015 was used to explore associations between increased numbers of contacts or improvements in quality and any change in the coverage of interventions (intervention coverage). In pregnancy, in multiple regression, an increase in the quality indicator ‘focused ANC behaviours’ was associated with a change in both the coverage of iron supplementation and syphilis prevention ((regression coefficients (95% CI)) 0·06 (0·01, 0·11); 0·07 (0·04, 0·10)). This equates to a 0.6% increase in the proportion of women taking iron supplementation and a 0.7% in women receiving syphilis prevention for a 10% increase in the quality indicator ‘focused ANC behaviours’. At delivery, in multiple regression the quality indicator ‘availability of uterotonic supplies amongst birth attendants’ was associated with improved coverage of prophylactic uterotonics (0·72 (0·50, 0·94)). No evidence of any relationships between contacts, quality and intervention coverage were observed within the early postnatal period.ConclusionsIncreases in both contacts and in quality of care are needed to increase the coverage of life saving interventions. For interventions that need to be delivered at multiple visits, such as antenatal vaccination, increasing the number of contacts had the strongest association with coverage. For those relying on a single point of contact, such as those delivered at birth, we found strong evidence to support current commitments to invest in both input and process quality.

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“…The missed opportunity analyses are based on the assumption that each individual intervention is scaled up from the current coverage to 90% during the subsequent year. In the absence of universal access to the stipulated interventions, potential undernutrition and death are termed ‘missed opportunities’ 41…”

Section: Methodsmentioning

confidence: 99%

“…There are a number of scientific publications based on LiST in different geographical settings 29 36–40. The missed opportunity tool within LiST has been used for prioritising interventions 41. A detailed description, utility, assumptions, application and update of LiST have been published in leading health and nutrition journals 30 33 42–45…”

Section: Introductionmentioning

confidence: 99%

Projecting stunting and wasting under alternative scenarios in Odisha, India, 2015–2030: a Lives Saved Tool (LiST)-based approach

Mishra¹,

Mohanty

Mittra³

et al. 2019

BMJ Open

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ObjectiveAlthough nutrition-specific interventions are designed based on maternal, household and community-level correlates, no attempt has been made to project stunting and wasting and identify intervention priorities in India. The objective of this paper is to model the stunting and wasting in the state of Odisha, India by scaling up maternal and child health interventions under alternative scenarios.DesignThis study primarily used data from National Family Health Survey 4, 2015–2016.MeasuresThe LiST (Lives Saved Tool) software is used to model the nutritional outcomes and prioritise interventions. The projections were carried out under four alternative scenarios: scenario 1—if the coverage indicators continued based on past trends; scenario 2—scaled up to the level of the richest quintile; scenario 3—scaled up to that of Tamil Nadu; and scenario 4—scaled up to an aspirational coverage level.ResultsIn 2015, out of 3.52 million under-5 children in Odisha, around 1.20 million were stunted. By 2030, the numbers of stunted children will be 1.11 million under scenario 1, 1.07 million under scenario 2, 1.09 million under scenario 3 and 0.89 million under scenario 4. The projected stunting level will be 25% under scenario 4 and around 31% under all other scenarios. By 2030, the level of wasting will remain unchanged at 20% under the first three scenarios and 4.3% under scenario 4. Appropriate complementary feeding would avert about half of the total stunting cases under all four scenarios, followed by zinc supplementation. Water connection at home, washing hands with soap and improved sanitation are other effective interventions.ConclusionSustaining the maternal and child health interventions, promoting evidence-based stunting and wasting reduction interventions, and a multisectoral approach can achieve the World Health Assembly targets and Sustainable Development Goals of undernutrition in Odisha.

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Using the missed opportunity tool as an application of the Lives Saved Tool (LiST) for intervention prioritization

Cited by 8 publications

References 21 publications

Facility conditions, obstetric and neonatal care practices, and availability of emergency obstetric and neonatal care in 72 rural health facilities in the Democratic Republic of the Congo: A cross-sectional study

Facility conditions, obstetric and neonatal care practices, and availability of emergency obstetric and neonatal care in 72 rural health facilities in the Democratic Republic of the Congo: A cross-sectional study

Associations between increased intervention coverage for mothers and newborns and the number and quality of contacts between families and health workers: An analysis of cluster level repeat cross sectional survey data in Ethiopia

Projecting stunting and wasting under alternative scenarios in Odisha, India, 2015–2030: a Lives Saved Tool (LiST)-based approach

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