Interventions

What are some key interventions to reduce newborn mortality?

Globally, over three quarters of newborn deaths result from three major preventable and treatable conditions: preterm birth, complications during childbirth, including asphyxia, and severe infections.

The good news is there are specific care practices and interventions that, when effectively adopted at high coverage, can substantially reduce the burden of newborn deaths. These high-impact behaviors and technical interventions range from easy-to-apply antibiotics to ensuring the baby is kept warm to initiating breastfeeding at birth. The challenges to effectively delivering these interventions include the need for contextually appropriate delivery strategies, adequate resources (human and infrastructure), and sufficiently robust support systems.

Antenatal corticosteroids

When preterm delivery is imminent, the administration of antenatal corticosteroids (ACS) can help fetal lungs mature more rapidly and, within the context of high-quality care, may improve chances of survival.

Treatment of potentially serious bacterial infection

Identifying severe infection and initiating appropriate antibiotic treatment early can dramatically increase a newborn’s chance of survival. Recent research has shown that when hospitalization is not possible, a safe, effective, and simpler antibiotic treatment for possibly serious bacterial infections (PSBI) can be provided in lower level facilities. Serious efforts need to be made to ensure hospitalization for the most severe cases.

Essential newborn care

Care of babies after birth by health workers and mothers – essential newborn care – promotes health and increases the chance of survival for all newborns. Many babies die during the first day and week because they do not receive these interventions. High-priority actions at birth and over the first hours of life include initiating breastfeeding within an hour of birth and ensuring protection from thermal stress, ideally with continuous skin-to-skin care.

Kangaroo mother care

Kangaroo mother care (KMC) represents optimal care for preterm newborns. It involves supporting mothers and other caregivers to keep newborns thermally stable and unstressed through continuous skin-to-skin contact on the mother’s chest; ensuring adequate feeding at suitable intervals, with additional support if the baby is unable to suckle; and vigilance to ensure prompt effective action in the case of difficulties or danger signs. In addition to reducing mortality risk, KMC has been shown to prevent infections; promote breastfeeding; regulate the baby’s temperature, breathing, and brain activity; and encourage mother-and-baby bonding.

Chlorhexidine for umbilical cord care

Ensuring optimal cord care at birth and during the first week of life, including use of chlorhexidine, especially in settings having poor hygiene, is a crucial strategy to prevent life-threatening sepsis and cord infections and avert preventable neonatal deaths.