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Introduction

The Children’s Investment Fund Foundation (CIFF) supported the Micronutrient Initiative (MI) to

conduct an intervention program titled “Reducing Deaths from Diarrhoea in the Indian State of Bihar,” in collaboration with the Government of Bihar. The goal of the program was to reduce child morbidity and mortality related to diarrhoeal disease among children under five through deployment of enhanced public sector delivery of ORS and Zinc for the treatment of diarrhoea in the state. The program was successfully implemented in 15 districts of Bihar between August 2011 and August 2015.

During the implementation phase, CIFF commissioned an independent evaluation. A team led by Christa Fischer Walker at the Institute for International Programs of the Department of International Health, Johns Hopkins Bloomberg School of Public Health (JHSPH) in association with Society for Applied Studies (SAS), New Delhi conducted a baseline survey in 15 districts in April – May 2011 and a midline survey in all 15 districts September – December 2013. Additionally, the midline assessment estimated the number of lives saved (or deaths averted) of children below five years of age by conducting the Lives Saved Tool (LiST) modelling to measure the (partial ) impact of MI’s ORS & Zinc program. Ingrid Friberg, formerly of the Institute for International Programs, led this modelling.

MI has successfully completed the implementation of the program in the selected 15 districts of the state as per the implementation plan for five years. This provides an opportunity for CIFF to measure the program achievements by estimating the number of children saved by the targeted intervention efforts to increase the coverage of ORS & Zinc for diarrhoea treatment.

Purpose of this specific modelling activity

As this program comes to a close, CIFF and MI wanted to estimate the number of child deaths averted by the Micronutrient Initiative (MI) ORS & Zinc Bihar program, using MI monitoring data, from August 2011 through April 2015, based on LiST modelling. The current modelling exercise updates the modelling and projections that Johns Hopkins University (JHSPH) conducted based on the ORS & Zinc coverage estimates from 2011 baseline and 2013 midline household surveys. CIFF and MI will use these estimates of deaths averted by the intervention in a program review meeting scheduled for late 2015.