Intervention heroes of Mozambique from 1997 to 2015: estimates of maternal and child lives saved using the Lives Saved Tool.

Ivalda Macicame, Amílcar Magaço, Marta Cassocera, Celeste Amado, Américo Feriano, Sérgio Chicumbe, Jorge Jone, Quinhas Fernandes, Kátia Ngale, Emilia Vignola, Caroline De Schacht, Timothy Roberton
Author Information
  1. Ivalda Macicame: Instituto Nacional de Saúde, Ministry of Health, Maputo, Mozambique.
  2. Amílcar Magaço: Instituto Nacional de Saúde, Ministry of Health, Maputo, Mozambique.
  3. Marta Cassocera: Instituto Nacional de Saúde, Ministry of Health, Maputo, Mozambique.
  4. Celeste Amado: Direcçăo Nacional de Saúde Pública, Ministry of Health, Maputo, Mozambique.
  5. Américo Feriano: Instituto Nacional de Saúde, Ministry of Health, Maputo, Mozambique.
  6. Sérgio Chicumbe: Instituto Nacional de Saúde, Ministry of Health, Maputo, Mozambique.
  7. Jorge Jone: Instituto Nacional de Saúde, Ministry of Health, Maputo, Mozambique.
  8. Quinhas Fernandes: Direcçăo Nacional de Saúde Pública, Ministry of Health, Maputo, Mozambique.
  9. Kátia Ngale: Johns Hopkins University - Bloomberg School of Public Health, Baltimore, Maryland, USA.
  10. Emilia Vignola: Johns Hopkins University - Bloomberg School of Public Health, Baltimore, Maryland, USA.
  11. Caroline De Schacht: Health Alliance International, Maputo, Mozambique.
  12. Timothy Roberton: Johns Hopkins University - Bloomberg School of Public Health, Baltimore, Maryland, USA.

Abstract

BACKGROUND: As one of several countries that pledged to achieve the Millennium Development Goals (MDGs), Mozambique sought to reduce child, neonatal, and maternal mortality by two thirds by 2015. This study examines the impact of Mozambique's efforts between 1997 and 2015, highlighting the increases in intervention coverage that contributed to saving the most lives.
METHODS: A retrospective analysis of available household survey data was conducted using the Lives Saved Tool (LiST). Baseline mortality rates, cause-of-death distributions, and coverage of child, neonatal, and maternal interventions were entered as inputs. Changes in mortality rates, causes of death, and additional lives saved were calculated as results. Due to limited coverage data for the year 2015, we reported most results for the period 1997-2011. For 2011-2015 we reported additional lives saved for a subset of interventions. All analyses were performed at national and provincial level.
RESULTS: Our modelled estimates show that increases in intervention coverage from 1997 to 2011 saved an additional 422 282 child lives (0-59 months), 85 450 neonatal lives (0-1 month), and 6528 maternal lives beyond those already being saved at baseline coverage levels in 1997. Malaria remained the leading cause of child mortality from 1997 to 2011; prematurity, asphyxia, and sepsis remained the leading causes of neonatal mortality; and hemorrhage remained the leading cause of maternal mortality. Interventions to reduce acute malnutrition and promote artemisinin-based combination therapy (ACT) for malaria were responsible for the largest number of additional child lives saved in the 1997-2011 period. Increases in coverage of delivery management were responsible for most additional newborn and maternal lives saved in both periods in Mozambique.
CONCLUSION: Mozambique has made impressive gains in reducing child mortality since 1997. Additional effort is needed to further reduce maternal and neonatal mortality in all provinces. More lives can be saved by continuing to increase coverage of existing health interventions and exploring new ways to reach underserved populations.

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MeSH Term

Child Mortality
Child, Preschool
Female
Health Promotion
Humans
Infant
Infant Mortality
Infant, Newborn
Maternal Mortality
Mozambique
Pregnancy
Program Evaluation
Retrospective Studies
Software

Word Cloud

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