Prioritizing the needs of adolescents by building the evidence base for life‐saving impact of scaling up contraception and abortion for adolescents in Ethiopia, Malawi and Zambia using LiST

Systematic understanding of the life-saving impact of scaling up contraception and safe abortion interventions for adolescents is absent. The evidence that does exist does not disaggregate for this critical age group. There is an urgent need to understand how contraception and abortion care services can be provided for, and accessed by, adolescents. The Lives Saved Tool (LiST) is an open access modelling software, which estimates the impact of maternal and child health interventions on future outcomes (e.g.: lives saved, abortions averted). Using three country case studies-Ethiopia, Malawi, Zambia- the aim of this paper is to understand the health system costs and health outcomes of increased adolescent use of contraception and/or abortion-related care. We iteratively apply scenario building to ascertain how different interventions in both contraception and post abortion care, as well as safe abortion services, might affect adolescent health outcomes, both from the perspective of health system costs and lives saved. The scenarios have been informed by key informant interviews [n=9] in each of the countries to establish the quality of available data and the feasibility of future projections. Each of the three study countries has demonstrated high-level commitment to the development and provision of sexual and reproductive health services for adolescents, although the rate of roll-out and the implementation, legal and policy contexts are variable. The importance of this study is twofold: to increase awareness of the impact of sexual and reproductive health interventions for adolescents in low-resource settings; and, to demonstrate the novel use of LiST as a tool for impact measurement in the field of adolescent health