Annually, an estimated 2.3 million newborns die within their first 28 days, comprising nearly half of under-five deaths. Sustainable Development Goal target 3.2 calls for countries to reduce neonatal deaths to <12 per 1000 live births by 2030. Meeting this SDG target necessitates countries reaching high coverage and quality for WHO level-2 neonatal services, including respiratory support with continuous positive airway pressure for preterm babies. Countries needing the most acceleration are in sub-Saharan Africa where 1 million babies die needlessly from preventable causes each year. Faster progress requires 80% of districts to have functioning small and sick newborn care units with level-2 newborn care, including the right infrastructure, devices, data, and skilled staff, necessitating systems change.
NEST360 (Newborn Essential Solutions and Technologies) alliance have compiled a series of papers sharing evidence-based tools and learnings for the scale-up of effective SSNC from four countries in sub-Saharan Africa, and relevant beyond. NEST360 is an alliance of 20 organisations, 17 in Africa, with four African country governments: Kenya, Malawi, Nigeria, and Tanzania. NEST360 is supporting these governments to implement a health systems package for high-quality level-2 small and sick newborn care. Frontline clinicians, biomedical technicians, and quality improvement leaders form a learning network in more than 67 facilities across the four countries. Ethiopia is joining the Alliance.
The team of >100 authors is interdisciplinary, international, and diverse, with the majority from Africa, where neonatal mortality is highest. Papers in this supplement inform implementation for high-quality newborn care in low- and middle-income contexts, including co-development of standardised data tools, systematic approaches to device selection, costing and set-up, education modules, and approaches to help catalyse investment. Many of the tools are open access on www.newborntoolkit.org
