Reducing neonatal mortality is an essential part of the third Sustainable Development Goal (SDG), to end preventable child deaths. Between 1990 and 2017, the global NMR decreased by 51%  from 36·6 deaths per 1000 livebirths in 1990, to 18·0 deaths per 1000 livebirths  in 2017. Between 2018 and 2030, it is projected that 27·8 million children will die in their first month of life if each country maintains its current rate of reduction in NMR. If each country achieves the SDG neonatal mortality target of 12 deaths per 1000 livebirths or fewer by 2030, 22·7 million cumulative neonatal deaths are projected by 2030-saving 6 million babies! More than 60 countries need to accelerate their progress to reach the neonatal mortality SDG target by 2030.

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More mothers are attending health facilities to deliver their babies, yet 2.6 million babies are stillborn every year, more than a third (42%) of those in Sub-Saharan Africa. What approaches can we apply to prevent stillbirths?

Pregnancy should be a time of joyful anticipation about the arrival of a new family member. But each year, 2.6 million babies are stillborn. Half these babies die during labour.¹

More than half a million of these are in Sub-Saharan Africa despite two thirds of all women giving birth in health facilities.¹

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On the 15th of May we celebrated International KMC awareness day. We hope you all held special events at your hospital or took the KMC challenge?

Click the link below to access resources to support implementation of KMC in your facility.

As management of respiratory distress syndrome (RDS) advances, clinicians must continually revise their current practice. Find a link below for the fourth update of “European Guidelines for the Management of RDS” by a European panel of experienced neonatologists and an expert perinatal obstetrician based on available literature up to the end of 2018. Optimising outcome for babies with RDS includes prediction of risk of preterm delivery, need for appropriate maternal transfer to a perinatal centre and timely use of antenatal steroids. Delivery room management has become more evidence-based, and protocols for lung protection including initiation of CPAP and titration of oxygen should be implemented immediately after birth. Surfactant replacement therapy is a crucial part of management of RDS, and newer protocols for its use recommend early administration and avoidance of mechanical ventilation. Methods of maintaining babies on non-invasive respiratory support have been further developed and may cause less distress and reduce chronic lung disease. As technology for delivering mechanical ventilation improves, the risk of causing lung injury should decrease, although minimising time spent on mechanical ventilation using caffeine and, if necessary, postnatal steroids are also important considerations. Protocols for optimising general care of infants with RDS are also essential with good temperature control, careful fluid and nutritional management, maintenance of perfusion and judicious use of antibiotics all being important determinants of best outcome.

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A research group based at KEMRI-Wellcome Trust – Kenya and Oxford University has developed a free smartphone app for training health workers called “LIFE” which was launched during the Kenya Paediatric Association 2019 annual conference in Mombasa, Kenya.

The Life-saving Instruction for Emergencies (LIFE) smartphone app uses interactive 3D simulations of life-threatening emergencies to train healthcare workers to save lives. The simulations take place in a virtual 3D hospital where users have to find the correct pieces of medical equipment to manage an emergency and then use this equipment to carry out a sequence of life-saving steps. At the end of the simulated emergency, if they have carried out the steps correctly, the LIFE system awards a digital Continuing Professional Development (CPD) credit that is registered with the Kenya Paediatric Association (KPA).

There is a desperate need for new methods to train the growing numbers of healthcare workers around the world, particularly for managing emergencies in children. In Africa, approximately 1 million children die in their first month of life and the World Health Organization (WHO) estimates that two-thirds of these children could be saved if the healthcare workers who look after them had adequate training and resources.

Currently available face-to-face training programmes for healthcare workers are expensive and are associated with knowledge decay over time requiring frequent refresher training which only adds to the cost and inconvenience. To overcome these challenges, LIFE has been designed as a freely available app that all healthcare workers can download onto their own smartphones. The LIFE app reminds users on their phones when they need to refresh their training so that they can quickly test their knowledge to ensure they are always ready to act in an emergency. The LIFE app issues CPD credits each time they refresh their knowledge so that healthcare workers are rewarded with professional recognition for keeping up-to-date.

The development of the LIFE app was initially funded by contributors to a crowdfunding campaign, including the Skoll Foundation, HTC, and Medicins Sans Frontieres, with matched funding from the Wellcome Trust. The LIFE team went on to win funding from the Saving Lives at Birth Grand Challenge for Development (funded by the Bill and Melinda Gates Foundation, USAID, DFID, KOICA and Grand Challenges Canada). In 2018, LIFE won the “VR for Impact” award from HTC at the World Economic Forum in Davos to develop a Virtual Reality version of the app.

Healthcare workers around the world can now download the LIFE app for free from or the Google PlayStore

For babies who are born healthy, the World Health Organisation (WHO) recommends to delay cord clamping . It means that the umbilical cord is not clamped immediately after birth but after waiting one to three minutes. That way, the baby is still connected to the placenta and receives oxygen rich blood and essential nutrients.
However, ill or preterm born babies often require immediate care and are therefore removed from the mother. This is where Concord Neonatal, a start-up from the Netherlands, come into play: they just introduced a new solution, Concord, that enables caregivers to provide care immediately after birth with the umbilical cord still intact until the baby is stable and breathing on its own.

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The European Standards for Newborn health were launched at the end of 2018 with a call to action. 220 health professionals and parent organisations from 30 countries were involved in developing the standards which cover 11 broad themes from birth through to ongoing infant and family centred care.

An information booklet on the standards can be found here:

And the standards are available for download here:


Image result for european standards of care for newborn health

We recently came across an interesting leadership book-The Leadership Challenge by Kouzes and Posner.

It sets out 5 Practices and 10 Commitments for exemplary leadership. We challenge you to ask yourself how many of the 10 commitments you meet as a leader? It might be food for thought and prompt revision of your leadership style?!

Click below for a PDF of the book :

and here for a link to their website:

Nigeria’s ‘Flying Midwives’ Are Helping Save Moms and Babies

Nigeria is a risky place to give birth. Around 58,000 mothers die in childbirth in Nigeria every year, and 240,000 newborns within 28 days of birth. Despite being the wealthiest country in Africa by GDP, it ranks fourth in maternal mortality globally. But the situation is especially bad in the northeast of the country. Here in Borno state, which is at the epicenter of a decade–long Islamist insurgency led by Boko Haram, more than 6,500 newborns die every year of preventable causes—twice the rate of the rest of the country, according to the Nigerian government. And approximately 3,500 to 4,500 women die yearly because of causes related to childbirth.

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Early total enteral feeding – An effective intervention to improve outcomes in very low birth weight (VLBW) neonates in resource limited settings.

Early appropriate nutrition and infection prevention are vital for the survival of a preterm infant. These issues are interconnected when delayed enteral feeds leads to intravenous intervention, which can result in infection.

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