Renewing hope: A global push to improve neonatal outcomes
Each year, about 2.3 million newborns die worldwide: an average of four newborn deaths every minute. In 2000, the United Nations launched the Millennium Development Goals (MDG), calling for a two-thirds reduction in child and neonatal mortality by 2015. This mobilized global interest, funding and initiatives to improve maternal, neonatal and child health and to narrow gaps in disparate outcomes between high- and low- income countries. While significant progress occurred in reducing maternal and under age 5 mortality, improvements in neonatal outcomes lagged behind. By 2015, the MDG target for child health remained unmet, with 98% of neonatal deaths still occurring in low- and middle-income countries (LMIC).
In 2015, the UN introduced the Sustainable Development Goals (SDG), setting even more ambitious targets to catalyze progress, end preventable deaths and reduce global neonatal mortality to an even lower goal by 2030. Yet, nearly half of all child deaths now occur within the first 28 days of life and prematurity has become the leading cause of death in children under the age of 5 worldwide. At the current pace, the world is not on track to meet the SDG targets without a renewed global focus on improving neonatal outcomes.
In LMICs, resource limitations extend well beyond municipal infrastructure (such as water, power and roads) to include critical shortages in skilled healthcare providers, space, medications and affordable equipment. Recent government funding cuts have further complicated an already challenging environment but have presented a larger opportunity for foundations and philanthropies to step in and offer support.
While large-scale funding is beneficial, many low-cost, evidence-based interventions, such as antenatal corticosteroids and immediate ‘kangaroo mother care’ for preterm infants, remain underutilized in LMICs. The World Health Organization’s Every Newborn Action Plan and Every Woman Every Newborn Everywhere provide strategic objectives with proposed action plans to advance newborn care. Guiding implementation of these interventions while adapting to the local context is a tangible path to continue progress.
Other impactful strategies involve long-term partnerships offering expert time to mentor and train residents and fellows, teach educational curriculums to frontline staff, hands on skills training through simulation, and quality improvement mentoring to sustain gains. Much of this expert advising, teaching and mentoring can now be delivered through telemedicine and remote learning platforms. The WHO Essential Newborn Care Course is a great example of training curriculum to strengthen knowledge and skills for newborn resuscitation and basic care. The online version of the curriculum as well as other resources can be accessed here. Finally, academic institutions (Texas Children’s Global Health Network and Baylor College of Medicine Global Programs), and the American Academy of Pediatrics are excellent entry points for those seeking involvement in global health.
Every newborn deserves the chance to survive and thrive, regardless of where they are born. Yet neonatal mortality remains unacceptably high in low- and middle-income countries. To put it in perspective: in the four minutes you have spent reading this blog, approximately 16 newborns have died. Despite this, hope remains. Meaningful progress happens when people everywhere, not just in LMICs, commit to improving newborn survival through shared purpose, compassion and action.
By Dr. Monika Patil, associate professor of pediatrics, division of neonatology, Baylor College of Medicine, Texas Children’s Hospital
