Lives Saved Tool (LiST): How to create a sub-national projection

1. Lives Saved Tool (LiST):How to create a sub-national projection Ingrid Friberg, PhD

2. Why create a sub-national projection? • Demography is the basis of all child survival data • Birth counts for baseline • Noticeably different than national information • i.e India vs. Kerala • Separate urban and rural • To use over and over again

3. SADHS, 1998

4. What demographic data is needed?

5. Edit – Demography (DemProj)

7. How to create a sub-national projection? • Easy • Assume national trends are essentially correct • Multiply to get the proportion of the country • Hard • Assume nothing • Identify regional data and enter it

8. Create a sub-national projection: the easy way • Create a national projection • Use EasyProj (population, fertility, mortality) • Generate the sub-national population • Multiply the first year population by the percent of the total in the sub-national area • Adjust the migration values • Save for reuse

9. 1) Select entire population 2) Click multiply 3) Enter the percent of the total in the sub-population

10. National migrant numbers need to be adjusted to reflect sub-population changes.

11. Limitations and Strengths Limitations Strengths Easy Can reuse the same time frame over and over Reasonably accurate • Can’t change the time frame (yet) • May deliver inaccurate births counts • If using AIM, need to adjust this as well

12. Creation of sub-national projection: the hard way • Collect data for a specific baseline year + trend • Create a national projection • Do NOT use EasyProj • Enter the sub-national data • Save this projection • Can modify underlying tables to reflect the new data (optional)

13. Where is the data from? • Census data • National surveys • Sub-national surveys • DHS

14. Limitations and Strengths Limitations Strengths Very accurate Can reuse with all time periods of interest (if you change underlying tables) • Time consuming • May need to estimate some parameters • If the data is wrong, the projection is wrong

15. Other options • Combining the easy and the hard way • Run EasyProj • Use multiply to get population information (if you don’t have it) • Enter all known available data

16. Example:South Africa – Eastern Cape • Start with AIM • Runs 1970-2015 • DemProj already run • Altered all numbers to percents • Adult ART, child ART, cotrimoxazole • Edit DemProj

18. SADHS, 1998

19. Data Collected • 1st year pop - 2001 Census • TFR - SADHS 1998 • ASFR - Default • SexRatio - Default • Life Expectancy - Health Systems Trust • Life Table - Default • Migration - State of SA population report

20. Example:South Africa – Eastern Cape • Start with AIM • Runs 1970-2015 • Altered all numbers to percents • Adult ART, child ART, cotrimoxazole • Edit DemProj • Population, Migration, TFR, Life Expectancy • Add LiST • Adjust mortality rates to reflect HIV • Edit child survival data and coverage data • Increase facility delivery from 74-96%

21. Scaling up facility based births from 74% to 95%prevents~6% of all deaths and ~18% of neonatal deaths

22. Example – Brazil Rio Grande do Sul • New Projection • Run EasyProj (1996-2015) • Edit Projection • Data from 1996 Census, 1996 DHS survey • Population 1996, TFR, Life expectancy… • Add LiST • Adjust NMR (11), IMR (19), U5MR (22) • Adjust other data…

23. Results • Kangaroo Mother Care (0-70%) • Prevents 95 deaths • Preventive Postnatal Care (0-70%) • Prevents 290 deaths • Pneumococcal vaccine (0-99%) • Prevents 128 deaths • Conclusion: preventive postnatal care might be a good area to invest in here

24. More information? • DemProj manual • English, French, Russian, Spanish • www.healthpolicyinitiative.com/index.cfm?id= software&get=Spectrum • www.healthpolicyinitiative.com • www.futuresinstitute.org/pages/spectrum.aspx • Local demographer • ifriberg@jhsph.edu