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1.
Background
A number of data sets show that high parity births are associated with higher child mortality than low parity births. The reasons for this relationship are not clear. In this paper we investigate whether high parity is associated with lower coverage of key health interventions that might lead to increased mortality.Methods
We used DHS data from 10 high fertility countries to examine the relationship between parity and coverage for 8 child health intervention and 9 maternal health interventions. We also used the LiST model to estimate the effect on maternal and child mortality of the lower coverage associated with high parity births.Results
Our results show a significant relationship between coverage of maternal and child health services and birth order, even when controlling for poverty. The association between coverage and parity for maternal health interventions was more consistently significant across countries all countries, while for child health interventions there were fewer overall significant relationships and more variation both between and within countries. The differences in coverage between children of parity 3 and those of parity 6 are large enough to account for a 12% difference in the under-five mortality rate and a 22% difference in maternal mortality ratio in the countries studied.Conclusions
This study shows that coverage of key health interventions is lower for high parity children and the pattern is consistent across countries. This could be a partial explanation for the higher mortality rates associated with high parity. Actions to address this gap could help reduce the higher mortality experienced by high parity birth.2.
Background
Studies on maternal exposure to polychlorinated biphenyls (PCBs) reported inconsistent findings regarding birth weight: some studies showed no effect, some reported decreased birth weight, and one study found an increase in weights. These studies used different markers of exposure, such as measurement of PCBs in maternal serum or questionnaire data on fish consumption. Additionally maternal exposures, such as dichlorodiphenyl-dichloroethylene (DDE), which are related to PCB exposure and may interfere with the PCB effect, were rarely taken into account.Methods
Between 1973 and 1991, the Michigan Department of Community Health conducted three surveys to assess PCB and DDE serum concentrations in Michigan anglers. Through telephone interviews with parents, we gathered information on the birth characteristics of their offspring, focusing on deliveries that occurred after 1968. We used the maternal organochlorine (OC) measurement closest to the date of delivery as the exposure. Although one mother may have contributed more than one child, serum concentrations derived from measurements in different surveys could vary for different children from the same mother. The maternal DDE and PCB serum concentrations were categorized as follows: 0 -< 5 microg / L, 5 -< 15 microg / L, 15 -< 25 microg / L, ≥25 microg / L. Using repeated measurement models (Generalized Estimation Equation), we estimated the adjusted mean birth weight controlling for gender, birth order, gestational age, date of delivery as well as maternal age, height, education, and smoking status.Results
We identified 168 offspring who were born after 1968 and had maternal exposure information. We found a reduced birth weight for the offspring of mothers who had a PCB concentration ≥25 microg / L (adjusted birth weight = 2,958 g, p = 0.022). This group, however, was comprised of only seven observations. The association was not reduced when we excluded preterm deliveries. The birth weight of offspring was increased in women with higher DDE concentrations when controlling for PCBs; however, this association was not statistically significant.Conclusion
Our results contribute to the body of evidence that high maternal serum PCB concentration may reduce the birth weight in offspring. However, only a small proportion of mothers may actually be exposed to PCB concentrations ≥25 microg / L.3.
Yacobou Sanoussi 《BMC health services research》2017,17(2):699
Background
Access to maternal and child health care in low- and middle-income countries such as Togo is characterized by significant inequalities. Most studies in the Togolese context have examined the total inequality of health and the determinants of individuals’ health. Few empirical studies in Togo have focused on inequalities of opportunity in maternal and child health. To fill this gap, we estimated changes in inequality of opportunity in access to maternal and child health services between 1998 and 2013 using data from Togo Demographic and Health Surveys (DHS).Method
We computed the Human Opportunity Index (HOI)—a measure of how individual, household, and geographic characteristics like sex and place of residence can affect individuals’ access to services or goods that should be universal—using five indicators of access to healthcare and one composite indicator of access to adequate care for children. The five indicators of access were: birth in a public or private health facility; whether the child had received any vaccinations; access to prenatal care; prenatal care given by qualified staff; and having at least four antenatal visits. We then examined differences across the two years.Results
Between 1998 and 2013, inequality of opportunities decreased for four out of six indicators. However, inequalities increased in access to antenatal care provided by qualified staff (5.9% to 12.5%) and access to adequate care (27.7% to 28.6%).Conclusions
Although inequality of opportunities reduced between 1998 and 2013 for some of the key maternal and child health indicators, the average coverage and access rates underscore the need for sustained efforts to ensure equitable access to primary health care for mothers and children.4.
Kimberly A. Greder Cheng Peng Kimberly D. Doudna Susan L. Sarver 《Child & youth care forum》2017,46(5):703-720
Background
Exposure to multiple stressors and lack of access to resources place rural children at high risk for adverse consequences. Family Stress Model guided this study to examine relations between two stressors- food insecurity and maternal depressive symptoms, and behavior problems among younger and older rural children.Objective
To test associations between food insecurity, maternal depressive symptoms, and behavior problems among younger and older rural low-income children.Methods
Cross-sectional data from 370 low-income rural families across 13 states was analyzed using structural equation modeling and multiple group analyses. Mothers’ education level, household income, marital/partner status, and participation in SNAP served as covariates.Results
Among younger children, maternal depressive symptoms partially mediated the relation between food insecurity and child externalizing behaviors, while among older children, maternal depressive symptoms completely mediated the relation between food insecurity and child internalizing and externalizing behaviors.Conclusions
Stress manifested directly from, or indirectly through, maternal depressive symptoms and from food insecurity was related to behavior problems among younger and older rural children; however, the relations varied by age of children. Programs and policies that prevent or lessen both food insecurity and maternal depression may help to lessen problem behaviors among on rural children. Longitudinal studies are needed to rigorously examine causation and directionality among food insecurity, maternal depression and rural child behavior problems, while accounting for influences of child, caregiver and family characteristics.5.
Machiko Minatoya Sachiko Itoh Keiko Yamazaki Atsuko Araki Chihiro Miyashita Naomi Tamura Jun Yamamoto Yu Onoda Kazuki Ogasawara Toru Matsumura Reiko Kishi 《Environmental health and preventive medicine》2018,23(1):43
Background
Studies reported adverse behavioral development including internalizing and externalizing problems in association with prenatal exposure to bisphenol A (BPA) and phthalates; however, findings were not sufficient due to using different assessment tools and child ages among studies. This study aimed to examine associations between maternal serum levels of BPA and phthalate metabolites and behavioral problems at preschool age.Methods
The Strengths and Difficulties Questionnaire (SDQ) was used to assess behavioral problems at 5 years of age. BPA and phthalate metabolite levels in the first trimester maternal serum was determined by LC-MS/MS for 458 children. Variables used for adjustment were parental ages, maternal cotinine levels, family income during pregnancy, child sex, birth order, and age at SDQ completed.Results
The median concentrations of BPA, MnBP, MiBP, MEHP, and MECPP, primary and secondary metabolites of phthalates, were 0.062, 26.0, 7.0, 1.40, and 0.20 ng/ml, respectively. MECPP level was associated with increase conduct problem risk (OR?=?2.78, 95% CI 1.36–5.68) overall and the association remained after child sex stratification, and odds ratios were increased with wider confidence interval (OR?=?2.85, 95% CI 1.07–7.57 for boys, OR?=?4.04, 95% CI 1.31–12.5 for girls, respectively). BPA, ∑DBPm (MnBP + MiBP), and ∑DEHPm (MEHP+MECPP) levels were not associated with any of the child behavioral problems.Conclusions
Our analyses found no significant association between BPA or summation of phthalate metabolite levels and any of the behavioral problems at 5 years of age but suggested possible association between MECPP levels and increased risk of conduct problems.6.
Background
Bangladesh has experienced a significant reduction of child mortality over the past decades which helped achieve the Millennium Development Goal 4 (MDG 4) target. But the mortality among under-5 aged children is still relatively high and it needs a substantial effort to achieve the Sustainable Development Goal (SDG) target and decelerate the current rate of under-5 mortality. At this stage, it is hence important to explore the trend and determinants of under-5 mortality in order to reduce the vulnerability of child’s survival. The aim of this study is to explore the trends and identify the factors associated with mortality in children aged less than 5 years in Bangladesh.Methods
Data from three repeatedly cross-sectional Bangladesh Demographic and Health Surveys (BDHSs) for the year 2007, 2011 and 2014 were used. A stratified two-stage sampling method was used to collect information on child and maternal health in these surveys. Cox’s proportional hazards models with community and mother level random effects (or frailty models) were fitted to identify the associated factors with under-five mortality.Results
Our study reveals that urban-rural disparity in child mortality has decreased over the time. The frailty models revealed that the combined effect of birth order and preceding birth interval length, sex of the child, maternal age at birth, mother’s working status, parental education were the important determinants associated with risk of child mortality. The risk of mortality also varied across divisions with Sylhet division being the most vulnerable one. Moreover, significant and sizable frailty effects were found which indicates that the estimations of the unmeasured and unobserved mother and community level factors on the risk of death were substantively important.Conclusion
Our study suggests that community-based educational programs and public health interventions focused on birth spacing may turn out to be the most effective. Moreover, unobserved community and familial effects need to be considered along with significant programmable determinants while planning for the child survival program.7.
Jihyun Sung 《Child & youth care forum》2018,47(2):233-257
Background
Despite widespread use of digital toys, research evidence of how a digital toy’s features affect children’s development and the nature of parent–child interactions during play is limited.Objective
The present study aimed to examine how mother–child dyads experience a traditional stuffed toy and an animated digital toy by comparing children’s conceptions of the toys, their play behaviors, and maternal interactive behaviors. The relationship pattern of how and degree to which children’s conceptions and maternal interactive behaviors are associated with children’s play were explored to examine how the toys’ animated and interactive function affected children’s play level and mother–child interaction.Method
Forty-eight children (mean age 49.77 months; 32 boys and 16 girls) and their mothers participated in the present study. Mother–child play with the toys was observed, and the children’s conceptions of the toys were obtained through interviews.Results
Children seemed to perceive that a digital puppy doll had psychological attributes. The mothers showed more interactive behaviors overall when playing with their children using digital toys. However, the associations between maternal interactive behaviors and children’s play in the two different play settings showed that a digital toy changed mother–child interaction owing to its technological features. Both children’s conception and maternal interactive behaviors of pretend play in the two different play contexts independently contributed to children’s pretense level.Conclusions
The current findings confirmed the facilitating as well as mediating effects of a digital toy on children’s play and the role of parents during play with digital toys.8.
Background
Studies clearly indicate that parenting practices relate to child externalizing behaviors, although the mechanisms underlying this relation are less well understood. There has been limited evaluation of child routines and self-regulation in relation to these variables, and no known studies have evaluated all of these variables simultaneously.Objective
This study examined child routines and self-regulation as serial mediators of the relations between positive and negative parenting practices (separately) and child externalizing problems among preschool children.Methods
Participants included 146 maternal caregivers of preschool children who completed measures of their parenting practices and of their child’s daily routines, self-regulation, and externalizing behaviors.Results
Results demonstrated that both child routines and self-regulation are significant mechanisms through which negative and positive parenting practices relate to externalizing problems in preschoolers, although the temporal sequencing was only upheld with respect to negative parenting. Our findings offer preliminary evidence that child routines may play a critical role in self-regulation development among preschool children, which, in turn, is inversely associated with externalizing behaviors.Conclusion
Although further study is needed, these findings suggest that child routines and self-regulation development may be key components to incorporate clinically and evaluate empirically among intervention programs designed to prevent early development of behavior problems in preschool children.9.
Hadi Ghasemi Seyedeh Reihaneh Mirdehghan Mahshid Namdari Fariborz Bayat 《Environmental health and preventive medicine》2016,21(6):446-449
Objective
To assess the impact of occupational factors on the sex ratio of dentists’ children.Methods
A randomly selected 501 Iranian dentists participated in a telephone interview. The participants were contacted by their mobile number to answer questions about demographic variables (gender, age, marriage status), practice-related variables (year of graduation as general or specialist dentist, years of clinical work, working hours, average number of radiographs taken in a day, and spouse’s job), and questions about their children (number, gender and date of birth of each child). Kruskal–Wallis and Chi-square tests served for statistical evaluation.Results
Of all participating dentists, 71 % were men, about two-thirds were 35- to 50-year olds, and 89 % were married. In total, the dentists had 768 children; about 21 % had no child. Of all the children, 54 % were boys (overall sex ratio = 1.17). The offspring sex ratio was 1.13 among male dentists, 1.50 for female dentists, and 1.44 when both parents were dentists. Higher percentages of boys were prevalent among female dentists, younger dentists, and general dental practitioners (p < 0.008).Conclusion
Demographic and practice-related factors showed some impact on proportions of both sexes of dentists’ children in this study. However, the result needs evaluation in further studies.10.
Nicole N. Lønfeldt Barbara H. Esbjørn Nicoline Normann Sonja Breinholst Sarah E. Francis 《Child & youth care forum》2017,46(4):577-599
Background
Recent research suggests that adults and children with anxiety disorders have a particular set of metacognitive beliefs and strategies. Knowing whether parents’ metacognitions, beliefs and behaviors are associated with their children’s metacognitions is important for understanding how anxiety-related metacognitions and clinical anxiety develop.Objective
We hypothesized that there are positive relationships between mother and corresponding child anxiety-related metacognitions even after controlling for maternal depression, anxiety and stress symptoms. We also hypothesized that maternal beliefs about child anxiety and maternal controlling behavior would be positively related to child metacognitions and would account for any associations between mother and child metacognitions.Methods
The study employed a cross-sectional design in a community sample of 7–12 year old children and their mothers. Mothers and children completed questionnaires to assess anxiety-related metacognitions and an interaction task to assess mothers’ overinvolvement. Mothers also completed questionnaires regarding their beliefs about child anxiety and controlling rearing behavior. We examined correlations between variables before investigating which maternal variables made unique contributions to the variation in children’s metacognitions in a series of multiple regressions and mediation analyses.Results
Mothers’ positive worry beliefs and cognitive confidence contributed a modest amount of unique variance in the corresponding beliefs in children. Mothers’ and children’s metacognitions were positively associated.Conclusions
The unique contributions of mothers’ anxiety-related metacognitions on children’s anxiety-related metacognitions found in our study indicate that a metacognitive-parental intervention for preventing and treating child anxiety is worth investigation. Our findings place anxious metacognitions in a developmental context.11.
Meghan M. Woods Bruce P. Lanphear Joseph M. Braun Lawrence C. McCandless 《Environmental health : a global access science source》2017,16(1):115
Background
Pregnant women are exposed to a mixture of endocrine disrupting chemicals (EDCs). Gestational EDC exposures may be associated with changes in fetal growth that elevates the risk for poor health later in life, but few studies have examined the health effects of simultaneous exposure to multiple chemicals. This study aimed to examine the association of gestational exposure to five chemical classes of potential EDCs: phthalates and bisphenol A, perfluoroalkyl substances (PFAS), polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), and organochlorine pesticides (OCPs) with infant birth weight.Methods
Using data from the Health Outcomes and Measures of Environment (HOME) Study, we examined 272 pregnant women enrolled between 2003-2006. EDC concentrations were quantified in blood and urine samples collected at 16 and 26 weeks gestation. We used Bayesian Hierarchical Linear Models (BHLM) to examine the associations between newborn birth weight and 53 EDCs, 2 organochlorine pesticides (OPPs) and 2 heavy metals.Results
For a 10-fold increase in chemical concentration, the mean differences in birth weights (95% credible intervals (CI)) were 1 g (-20, 23) for phthalates, -11 g (-52, 34) for PFAS, 0.2 g (-9, 10) for PCBs, -4 g (-30, 22) for PBDEs, and 7 g (-25, 40) for OCPs.Conclusion
Gestational exposure to phthalates, PFAS, PCBs, PBDEs, OCPs or OPPs had null or small associations with birth weight. Gestational OPP, Pb, and PFAS exposures were most strongly associated with lower birth weight.12.
Background
This paper provides empirical evidence on how the relationship between health expenditure and health outcomes varies across countries at different income levels.Method
Heterogeneity and cross-section dependence were controlled for in the panel data which consist of 161 countries over the period 1995–2014. Infant, under-five and maternal mortality along with life expectancy at birth were selected as health outcome measures. Cross-sectional augmented IPS unit root, panel autoregressive distributed lag, Dumitrescu-Hurlin and Toda-Yamamoto approach to Granger causality tests were used to investigate the relationship across four income groups. An impulse response function modelled the impact on health outcomes of negative shocks to health expenditure.Results
The results indicate that the health expenditure and health outcome link is stronger for low-income compared to high-income countries. Moreover, rising health expenditure can reduce child mortality but has an insignificant relationship with maternal mortality at all income levels. Lower-income countries are more at risk of adverse impact on health because of negative shocks to health expenditure. Variations in child mortality are better explained by rising health expenditure than maternal mortality. However, the estimated results showed dissimilarity when different assumptions and methods were used.Conclusion
The influence of health expenditure on health outcome varies significantly across different income levels except for maternal health. Policymakers should recognize that increasing spending has a minute potential to improve maternal health. Lastly, the results vary significantly due to income level, choice of assumptions (homogeneity, cross-section independence) and estimation techniques used. Therefore, findings of the cross-country panel studies should be interpreted with cautions.13.
Background
Several birth characteristics are associated with high mortality risk: very young or old mothers, short birth intervals and high birth order. One justification for family planning programs is the health benefits associated with better spacing and timing of births. This study examines the extent to which the prevalence of these risk factors changes as a country transitions from high to low fertility.Methods
We use data from 194 national surveys to examine both cross section and within-country variation in these risk factors as they relate to the total fertility rate.Results
Declines in the total fertility rate are associated with large declines in the proportion of high order births, those to mothers over the age of 34 and those with multiple risk factors; as well as to increasing proportions of first order births. There is little change in the proportion of births with short birth intervals except in sub-Saharan Africa. The use of family planning is strongly associated with fertility declines.Conclusions
The proportion of second and higher order births with demographic risk factors declines substantially as fertility declines. This creates a potential for reducing child mortality rates. Some of the reduction comes from modifying the birth interval distribution or by bringing maternal age at the time of birth into the ‘safe’ range of 18-35 years, and some comes from the actual elimination of births that would have a high mortality risk (high parity births).14.
Daniel?J?Corsi Diego?G?Bassani Rajesh?Kumar Shally?Awasthi Raju?Jotkar Navkiran?Kaur Prabhat?Jha 《BMC international health and human rights》2009,9(Z1):S3
Background
A variety of studies have considered the affects of India's son preference on gender differences in child mortality, sex ratio at birth, and access to health services. Less research has focused on the affects of son preference on gender inequities in immunization coverage and how this may have varied with time, and across regions and with sibling compositions. We present a systematic examination of trends in immunization coverage in India, with a focus on inequities in coverage by gender, birth order, year of birth, and state.Methods
We analyzed data from three consecutive rounds of the Indian National Family Health Survey undertaken between 1992 and 2006. All children below five years of age with complete immunization histories were included in the analysis. Age-appropriate immunization coverage was determined for the following antigens: bacille Calmette-Guérin (BCG), oral polio (OPV), diphtheria, pertussis (whooping cough) and tetanus (DPT), and measles.Results
Immunization coverage in India has increased since the early 1990s, but complete, age-appropriate coverage is still under 50% nationally. Girls were found to have significantly lower immunization coverage (p<0.001) than boys for BCG, DPT, and measles across all three surveys. By contrast, improved coverage of OPV suggests a narrowing of the gender differences in recent years. Girls with a surviving older sister were less likely to be immunized compared to boys, and a large proportion of all children were found to be immunized considerably later than recommended.Conclusions
Gender inequities in immunization coverage are prevalent in India. The low immunization coverage, the late immunization trends and the gender differences in coverage identified in our study suggest that risks of child mortality, especially for girls at higher birth orders, need to be addressed both socially and programmatically.Abstract in Hindi
See the full article online for a translation of this abstract in Hindi.15.
Background
With the world's largest population, HIV spread in China has been closely watched and widely studied by its government and the international community. One important factor that might contribute to the epidemic is China's numerous surplus of men, due to its imbalanced sex ratio in newborns. However, the sex ratio in the human population is often assumed to be 1:1 in most studies of sexually transmitted diseases (STDs). Here, a mathematical model is proposed to estimate the population size in each gender and within different stages of reproduction and sexual activities. This population profiling by age and gender will assist in more precise prediction of HIV incidences.Method
The total population is divided into 6 subgroups by gender and age. A deterministic compartmental model is developed to describe birth, death, age and the interactions among different subgroups, with a focus on the preference for newborn boys and its impact for the sex ratios. Data from 2003 to 2007 is used to estimate model parameters, and simulations predict short-term and long-term population profiles.Results
The population of China will go to a descending track around 2030. Despite the possible underestimated number of newborns in the last couple of years, model-based simulations show that there will be about 28 million male individuals in 2055 without female partners during their sexually active stages.Conclusion
The birth rate in China must be increased to keep the population viable. But increasing the birth rate without balancing the sex ratio in newborns is problematic, as this will generate a large number of surplus males. Besides other social, economic and psychological issues, the impact of this surplus of males on STD incidences, including HIV infections, must be dealt with as early as possible.16.
Naeem uddin Mian Mariam Zahid Malik Sarosh Iqbal Muhammad Adeel Alvi Zahid Memon Muhammad Ashraf Chaudhry Ashraf Majrooh Shehzad Hussain Awan 《Health research policy and systems / BioMed Central》2015,13(Z1):S57
Background
Pakistan is far behind in achieving the Millennium Development Goals regarding the reduction of child and maternal mortality. Amongst other factors, transport barriers make the requisite obstetric care inaccessible for women during pregnancy and at birth, when complications may become life threatening for mother and child. The significance of efficient transport in maternal and neonatal health calls for identifying which currently implemented transport interventions have potential for scalability.Methods
A qualitative appraisal of data and information about selected transport interventions generated primarily by beneficiaries, coordinators, and heads of organizations working with maternal, child, and newborn health programs was conducted against the CORRECT criteria of Credibility, Observability, Relevance, Relative Advantage, Easy-Transferability, Compatibility and Testability. Qualitative comparative analysis (QCA) techniques were used to analyse seven interventions against operational indicators. Logical inference was drawn to assess the implications of each intervention. QCA was used to determine simplifying and complicating factors to measure potential for scaling up of the selected transport intervention.Results
Despite challenges like deficient in-journey care and need for greater community involvement, community-based ambulance services were managed with the support of the community and had a relatively simple model, and therefore had high scalability potential. Other interventions, including facility-based services, public-sector emergency services, and transport voucher schemes, had limitations of governance, long-term sustainability, large capital expenditures, and need for management agencies that adversely affected their scalability potential.Conclusion
To reduce maternal and child morbidity and mortality and increase accessibility of health facilities, it is important to build effective referral linkages through efficient transport systems. Effective linkages between community-based models, facility-based models, and public sector emergency services should be established to provide comprehensive coverage. Voucher scheme integrated with community-based services may bring improvements in service utilization.17.
Marleen M. E. M. van Doorn Denise Bodden Mélou Jansen Ronald M. Rapee Isabela Granic 《Child & youth care forum》2018,47(4):481-498
Background
Informant discrepancies between mother and child have challenged the assessment, classification, and treatment of childhood anxiety. Despite numerous studies on this matter, the implications and consequences for research and clinical practice remain unclear.Objective
The present study aimed to obtain meaningful clinical information about informant discrepancies by examining mother–child agreement for anxiety subtypes, and by exploring mother–child discrepancies in relation to independent observer ratings of behavioral anxiety.Method
The screen for child anxiety related emotional disorders was administered to 79 mothers and clinically referred anxious children aged 7–13 years. Mother–child dyads were observed during an anxiety-provoking task and independent observers rated children’s observed anxiety.Results
The findings indicated a high level of mother–child disagreement on reports of anxiety. There was variability in levels of agreement between subtypes of anxiety, with significantly stronger mother–child agreement for separation compared to other forms of anxiety. Observed proximity between the mother and child was positively associated with child-reported separation anxiety and children’s observed anxious voice was negatively associated with child-reported panic disorder.Conclusions
The results highlight the need to incorporate a multi-informant assessment of childhood anxiety in clinical practice and research, in particular for subtypes of anxiety problems that are characterized by less observable and more internally experienced components.18.
Background
The Lives Saved Tool (LiST) is a computer-based model that estimates the impact of scaling up key interventions to improve maternal, newborn and child health. Initially developed to inform the Lancet Child Survival Series of 2003, the functionality and scope of LiST have been expanded greatly over the past 10 years. This study sought to “take stock” of how LiST is now being used and for what purposes.Methods
We conducted a quantitative survey of LiST users, qualitative interviews with a smaller sample of LiST users and members of the LiST team at Johns Hopkins University, and a literature review of studies involving LiST analyses.Results
LiST is being used by donors, international organizations, governments, NGOs and academic institutions to assist program evaluation, inform strategic planning and evidenced-based decision-making, and advocate for high-impact interventions. Some organizations have integrated LiST into internal workflows and built in-house capacity for using LiST, while other organizations rely on the LiST team for support and to outsource analyses. In addition to being a popular stand-alone software, LiST is used as a calculation engine for other applications.Conclusions
The Lives Saved Tool has been reported to be a useful model in maternal, newborn, and child health. With continued commitment, LiST should remain as a part of the international health toolkit used to assess maternal, newborn and child health programs.19.
20.
Paola Di Blasio Elena Camisasca Sarah Miragoli Chiara Ionio Luca Milani 《Child & youth care forum》2017,46(5):685-701