lives saved tool (list): how to create a sub-national projection ingrid friberg, phd

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

projection

Ingrid Friberg, PhD

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

SADHS, 1998

What demographic data is needed?

Population by age group and gender Total fertility rate

Life expectancy by gender Age specific fertility rate

Life table Sex ratio at birth

International (sub-national) migration

Edit – Demography (DemProj)

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

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

1) Select entire population2) Click multiply3) Enter the percent of the total in the sub-population

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

Limitations and Strengths

Limitations

• Can’t change the time frame (yet)

• May deliver inaccurate births counts

• If using AIM, need to adjust this as well

Strengths

• Easy• Can reuse the same time

frame over and over• Reasonably accurate

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)

Population by age group and gender Total fertility rate

Life expectancy by gender Age specific fertility rate

Life table for mortality Sex ratio at birth

International (sub-national) migration

Where is the data from?

• Census data

• National surveys

• Sub-national surveys

• DHS

Limitations and Strengths

Limitations

• Time consuming• May need to estimate

some parameters• If the data is wrong, the

projection is wrong

Strengths

• Very accurate• Can reuse with all time

periods of interest (if you change underlying tables)

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

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

SADHS, 1998

Urban Non-urban

12.4% 12.6%

25.0 22.7

27.2 22.2

19.5 19.0

11.7 14.1

4.0 6.4

0.2 3.1

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

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%

Scaling up facility based births from 74% to 95%prevents

~6% of all deaths and ~18% of neonatal deaths

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…

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

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