ANALYSIS OF THE EFFICIENCY OF HEALTH MEASURES TO RAISE THE PROBABILITY OF CHILD SURVIVAL IN DEVELOPING COUNTRIES

Evaluation covers the period 6/1/76-8/31/79 and summarizes the conclusions of a review done by A.I.D."s Research Advisory Committee (RAC). RAC found that the mathematical model developed by Michigan State University (MSU) is technically and scientifically sound and illustrates well the basic choices facing decisionmakers who seek a rational, efficient health intervention system under given resource constraints. If used correctly, the model would encourage a more logical and systematic structure for thinking about health intervention decisions. It is flexible enough to have application in any locality and can be used for any age group and population, although it is specifically directed at children under five. The model could be especially useful for Food for Peace and other nutrition programs, immunization, maternal child health, and disease control efforts. The model was tested on empirical data and was able to reproduce mortality data very well. The model indicates that promotional programs and water, sanitation, and nutrition interventions have the greatest impact on morbidity. The highest cost activities are in-patient care, while the least costly are health promotions such as latrines and well-baby clinics. The model does have shortcomings. Due to short-cuts in its application, the modified Delphi technique used to collect estimates for impacts of various interventions on mortality is the model"s weakest link. Moreover, the non-linear optimization procedure used makes for a discouraging complexity -- the computer programming technology needed to obtain solutions with the model is at present beyond the capabilities of many LDC"s. To increase awareness of the model and its potential utility, A.I.D. should (1) prepare a simplified version of MSU"s final report and distribute it to Missions and LDC institutions; (2) apply the model to a fairly large project in a particularly resource-short country; and (3) incorporate the model into future health and nutrition programs.