From: Coverage and inequalities in maternal and child health interventions in Afghanistan
The Lives Saved Tool is a modelling software which has been used extensively over the past 10Â years to estimate the potential impact of scaling up community and facility based interventions on mortality [20]. We used this analysis to assess the impact of community based interventions on neonatal and post neonatal mortality at the wealth quintile level. Data from the MICS 2010 were used for baseline estimates of health status, mortality and intervention coverages as required for LiST modeling. Current cause of death structure by wealth quintiles were not available for Afghanistan and we thus used LiST to compute these following procedures as per the method of Amouzou et al [32]. We modelled the impact of interventions amenable to scale up through first level health services and community platforms to reach deprived population sub-groups, as described in the recent childhood diarrhea and pneumonia [33] and nutrition series [34] for addressing inequities. A set of 12 interventions were scaled up from their most recent coverage level to 90Â % by the year 2025 employing community-based approaches targeting the poor, usually rural and remote populations. Modelled interventions are listed in the box below. | |
Impact on Neonatal or Post-neonatal Deaths | Effective Community-based Interventions |
Both | Maternal micronutrient supplementation (iron, multiple micronutrients) |
Both | Breastfeeding promotion |
Post-neonatal | Complementary feeding promotion |
Post-neonatal | Vitamin A supplementation |
Post-neonatal | Promotion of hand washing practices |
Neonatal | Chlorohexidine |
Neonatal | Thermal care |
Both | Oral rehydration solutions (ORS) |
Post-neonatal | Zinc for diarrhea treatment |
Neonatal | Oral antibiotics for treatment of neonatal infections |
Post-neonatal | Oral antibiotics for treatment of pneumonia |
Post-neonatal | Severe Acute Malnutrition (SAM) management -therapeutic feeding for severe wasting -treatment for moderate acute malnutrition |