Prioritizing Countries for Interventions to Reduce Child Mortality: Tools for Maximizing the Impact of Mass Drug Administration of Azithromycin

Alastair I Matheson, Lisa E Manhart, Patricia B Pavlinac, Arianna R Means, Adam Akullian, Gillian A Levine, Julie Jacobson, Erin Shutes and Judd L Walson

PLOS ONE, 2014, vol. 9, issue 5, 1-6

Abstract: Background: As new interventions to reduce childhood mortality are identified, careful consideration must be given to identifying populations that could benefit most from them. Promising reductions in childhood mortality reported in a large cluster randomized trial of mass drug administration (MDA) of azithromycin (AZM) prompted the development of visually compelling, easy-to-use tools that synthesize country-specific data on factors that would influence both potential AZM benefit and MDA implementation success. Methodology/Principal Findings: We assessed the opportunity to reduce mortality and the feasibility of implementing such a program, creating Opportunity and Feasibility Indices, respectively. Countries with high childhood mortality were included. A Country Ranking Index combined key variables from the previous two Indices and applied a scoring system to identify high-priority countries. We compared four scenarios with varying weights given to each variable. Conclusions/Significance: These visually accessible tools can be adapted or refined to include other metrics deemed important by stakeholders, and provide a quantitative approach to prioritization for intervention implementation. The need to explicitly state metrics and their weighting encourages thoughtful and transparent decision making. The objective and data-driven approach promoted by the three Indices may foster more efficient use of resources.

Date: 2014
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0096658

DOI: 10.1371/journal.pone.0096658

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