Problem - NEST

The Neonatal Health Crisis

At the beginning of 2016, the United Nations established 17 Sustainable Development Goals (SDGs) within the 2030 Agenda for Sustainable Development. The SDG 3 “Ensure healthy lives and promote well-being for all at all ages” specifically targets ending preventable deaths of newborns and children under five years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births by 2030 (target 3.2), which can be reached only if stakeholders globally encourage and strengthen local partnerships (SDG 17).

Throughout the years, significant progress has been made in reducing under-five mortality. However, progress has not been as rapid in reducing neonatal mortality rate (NMR ). The first 28 days of life – the neonatal period – is the most vulnerable time for a child’s survival.

FIGURE 1.

Under-five, 1-59 months, and neonatal mortality rates, 1990-2021, UN IGME 2022

Geographical disparities

Despite decades of global health initiatives and advancements in medical technology, neonatal mortality rates in sub-Saharan Africa remain unacceptably high. This region, marked by complex socio-economic challenges and strained healthcare systems, continues to face a disproportionate burden of newborn deaths, presenting a persistent and pressing crisis.

The situation demands urgent and innovative solutions that address the root causes of mortality and morbidity, ensuring equitable access to quality care for all newborns. Understanding the scale and scope of this crisis is the first critical step towards meaningful change, highlighting the urgent need for targeted interventions. This challenge extends beyond mere statistics, deeply impacting families, communities, and the long-term development prospects of these already vulnerable nations. Investing in neonatal health is not just a moral imperative but also a strategic investment in the future, unlocking the potential of future generations.

FIGURE2.

Neonatal mortality rate by country, 2021, UN IGME 2022

While global efforts have led to a decline in the overall neonatal mortality rate, significant disparities persist, exposing the stark inequalities in healthcare access across the world. The sub-Saharan African region notably lags behind other areas, presenting a distressing contrast to regions like Australia and New Zealand, which exhibit far lower mortality rates. This disparity underscores the urgent need for targeted interventions designed to address the specific challenges faced by sub-Saharan African countries.

0
newborn deaths worldwide in 2023

0
are low-birth-weight and two-thirds are premature

0
of all under-five deaths occurred worldwide in 2023

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of these deaths are preventable

0
sub-Saharan Africa birth rate per woman

0/1,000
sub-Saharan Africa mortality rate

0
newborn deaths everyday

0
probability of death in the first month of life in sub-Saharan Africa compared to New Zealand

A complex scenario

Shortage of Specialized Human Resources

The shortage of well-trained doctors, nurses, and midwives specializing in neonatal care is a significant impediment to improving newborn health outcomes in sub-Saharan Africa. The region faces a critical need for healthcare professionals equipped with the knowledge and skills to provide essential newborn care services, including neonatal resuscitation, infection prevention, and Kangaroo Mother Care.

Building a sustainable healthcare workforce requires investing in comprehensive training programs, providing ongoing professional development opportunities, and fostering mentorship relationships between experienced and novice healthcare providers.

Equipment, Infrastructure and Resource Gaps

Inadequate medical equipment, fragile infrastructure, and limited access to essential supplies significantly impede the delivery of high-quality neonatal care in many parts of sub-Saharan Africa. Health facilities often lack basic tools such as incubators, phototherapy units, oxygen delivery systems, and infection-control resources; even when equipment is available, challenges related to maintenance, unreliable electricity and water supply, as well as limited staff capacity to operate it, often compromise its effective use.

Addressing these gaps requires coordinated investments in medical technology procurement, infrastructure upgrades, and robust maintenance systems, paired with strategies to ensure sustainable supply chains and technical support capacity at the facility level.

Lack of Data for Informed Decision-Making

The absence of reliable and comprehensive data on neonatal health outcomes hinders effective planning, monitoring, and evaluation of neonatal health programs.

The scarcity of data limits the ability of healthcare providers, policymakers, and researchers to accurately assess the needs of newborns. Strengthening data collection and analysis systems is essential for identifying trends, tracking progress, and allocating resources effectively. This calls for investing in data infrastructure, training healthcare workers in data collection techniques, and fostering a culture of data-driven decision-making.

Systemic Inequities in Access to Care

Deep-rooted social, economic, and geographic inequities disproportionately affect access to newborn health services.

Families living far from well-equipped health centers face barriers such as transportation challenges, financial constraints, and limited awareness of available services. Gender disparities, cultural norms, and structural discrimination can further restrict mothers’ ability to seek timely and appropriate care. These inequities contribute to delayed treatment, preventable complications, and ultimately higher neonatal mortality rates. Ensuring equitable access demands policies and strategies that strengthen community-level services, expand referral networks, reduce financial burdens, and promote culturally sensitive care practices.

Shortage of Specialized Human Resources

The shortage of well-trained doctors, nurses, and midwives specializing in neonatal care is a significant impediment to improving newborn health outcomes in sub-Saharan Africa. The region faces a critical need for healthcare professionals equipped with the knowledge and skills to provide essential newborn care services, including neonatal resuscitation, infection prevention, and Kangaroo Mother Care. Building a sustainable healthcare workforce requires investing in comprehensive training programs, providing ongoing professional development opportunities, and fostering mentorship relationships between experienced and novice healthcare providers.

Equipment, Infrastructure and Resource Gaps

Inadequate medical equipment, fragile infrastructure, and limited access to essential supplies significantly impede the delivery of high-quality neonatal care in many parts of sub-Saharan Africa. Health facilities often lack basic tools such as incubators, phototherapy units, oxygen delivery systems, and infection-control resources; even when equipment is available, challenges related to maintenance, unreliable electricity and water supply, as well as limited staff capacity to operate it, often compromise its effective use.

Addressing these gaps requires coordinated investments in medical technology procurement, infrastructure upgrades, and robust maintenance systems, paired with strategies to ensure sustainable supply chains and technical support capacity at the facility level.

Lack of Data for Informed Decision-Making

The absence of reliable and comprehensive data on neonatal health outcomes hinders effective planning, monitoring, and evaluation of neonatal health programs. The scarcity of data limits the ability of healthcare providers, policymakers, and researchers to accurately assess the needs of newborns. Strengthening data collection and analysis systems is essential for identifying trends, tracking progress, and allocating resources effectively. This calls for investing in data infrastructure, training healthcare workers in data collection techniques, and fostering a culture of data-driven decision-making.

Systemic Inequities in Access to Care

Deep-rooted social, economic, and geographic inequities disproportionately affect access to newborn health services. Families living far from well-equipped health centers face barriers such as transportation challenges, financial constraints, and limited awareness of available services. Gender disparities, cultural norms, and structural discrimination can further restrict mothers’ ability to seek timely and appropriate care. These inequities contribute to delayed treatment, preventable complications, and ultimately higher neonatal mortality rates.

Ensuring equitable access demands policies and strategies that strengthen community-level services, expand referral networks, reduce financial burdens, and promote culturally sensitive care practices.

To address and respond to this urgent problem, it is necessary to develop an intervention model that is consistent with the implementation context and sustainable over time, in collaboration with international partners and local communities.

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