An analysis of select Child Survival Project Data: How many Lives were saved?

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  • January 25, 2020
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  • Herrera, Andrew
    • Affiliation: Gillings School of Global Public Health, Public Health Leadership Program
Abstract
  • Background: Worldwide in 2015, there were 303,000 maternal deaths and 5,900,000 child deaths. Many of these deaths are readily preventable. Since 1983, Curamericas Global, a United States-based non-governmental organization, has worked in remote communities around the world with the aim of ending preventable deaths in women and children. Historically, Curamericas implemented projects with the United States Agency for International Development (USAID) Child Survival and Health Grants Program (CSHGP) using the Census-Based, Impact-Methodology (CBIO) and Care Groups. This paper associates lives were saved using a combination of the CBIO and Care Group methodologies. Care Groups ensure complete coverage, leverage resources and integrate peer-to-peer support and motivation. Independently and combined, CBIO and Care Groups are cost-effective and sustainable. The question arises how many maternal and children lives were saved by these projects, and at what cost? Methods: Using the final evaluations from six USAID CSHGP projects in three countries: Bolivia, Guatemala and Liberia, this paper will use changes in mortality ratios and external evaluations to estimate lives saved. Final evaluations of the projects also have costs of projects. While originally intended to project future lives saved during the scaling up of interventions, the LiST has been used to also retrospectively estimate the mortality impact of programs based on changes in demographic data and the coverage achieved of effective child survival interventions. Data available include changes in coverage for a variety of interventions related to maternal and child health collected at baseline, mid-term and end line of each program as well as final evaluations conducted by external program evaluators. A basic cost analysis will be done for total cost (from USAID and matching/cost share) per beneficiary and total cost per capita based on final evaluation and granting award documentation. Results: According to final evaluations, dramatic reductions in infant, child and maternal mortality rates were calculated. The final evaluations show that X out of Y goals were met. Further statistical analysis using the LiST approach will show true impact. Further tool development to take into account sustainability would also demonstrate additional impact. Limitations: Not all of the child survival project indicators match up exactly with LiST indicators, especially for projects implemented before LiST was established. There are potential confounders including culture, ministry of health involvement or lack thereof, and impacts of other interventions such as community-case management. Discussions and Conclusions: Reaching 403,137 people and 229,087 direct beneficiaries over 25 years (1987 – 2015, with three years without child survival projects) with total costs of $8,582,126, Curamericas Global has saved oved 1,201 lives through critical prevention and treatment of maternal and child illnesses. The Child Survival program implemented by USAID no longer supports these types of programs. If scaled up to reach more beneficiaries, even country wide, Curamericas Global and other NGOs could quickly and effectively contribute to the elimination of maternal and child mortality, accelerating the lofty goal.
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  • In Copyright
Note
  • Paper type: Research or research design
  • Track: Leadership
Advisor
  • Evarts, Lori
Reviewer
  • Perry, Henry
Degree
  • Master of Public Health
Academic concentration
  • Public Health
Degree granting institution
  • University of North Carolina at Chapel Hill
Graduation year
  • 2017
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  • b80267c9-6c11-4a75-902a-dd1f88698102

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