Annals of Tropical Medicine and Public Health

: 2016  |  Volume : 9  |  Issue : 6  |  Page : 414--415

Devising a comprehensive strategy to improve the neonatal health and survival rates in low-resource settings

Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy 
 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Kancheepuram, Tamil Nadu, India

Correspondence Address:
Saurabh RamBihariLal Shrivastava
Department of Community Medicine, 3rd Floor, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Devising a comprehensive strategy to improve the neonatal health and survival rates in low-resource settings.Ann Trop Med Public Health 2016;9:414-415

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Devising a comprehensive strategy to improve the neonatal health and survival rates in low-resource settings. Ann Trop Med Public Health [serial online] 2016 [cited 2020 Feb 27 ];9:414-415
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Full Text

Dear Sir,

Globally, close to 45% of the deaths reported among under-5 year age group each year has been reported among the newborns in their initial 28 days of life.[1] In fact, almost 75% of these neonatal deaths occur in the first 7 days of life itself.[1] Further, a major proportion of newborn deaths takes place in low-resource settings (weak health infrastructure and poor access to health care services), and hence most of these newborns die at home, due to the lack of availability of skilled care.[1],[2]

Even though, various causes have been identified which could have resulted in the deaths of newborn, almost four-fifth of the deaths has been attributed to prematurity, low-birth weight, infections, asphyxia, and birth injuries.[1] At the same time, three high-risk groups of newborn have also been ascertained, namely low-birth-weight (measures to prevent hypothermia, hypoglycemia, prompt recognition, and management of danger signs, etc.), sick newborns (provision of the desired standardized care in appropriate health care establishments through trained health care professionals), and newborns of HIV-infected mothers (administration of preventive antiretroviral treatment for mothers and newborns, services for HIV testing and care for the exposed newborn, and provision of counseling, and support to mothers for infant feeding), which require additional care and should be referred to a hospital.[1],[2],[3]

Further, it has been anticipated that almost 66% of the newborn deaths can be averted if effective health care services are delivered at birth and during the 1st week of life as it will enable early detection and management of the health problems.[1],[2] Acknowledging the fact that a major proportion of mothers who have delivered in health institutions cannot return for the postnatal care owing to financial/social constraints, especially in low-resource settings, the international health agencies have advocated for 2–3 home visits by a skilled health worker to improve the probability of newborn survival.[2] These home visits become indispensable in developing nations where <15% of the women who had delivered in domiciliary settings receives postnatal care within the first 24 h.[1],[2]

In addition, other interventions such as strengthening of the health care delivery system, measures to provide continuous financial support, training of the health professionals in different aspects of newborn care, ensuring 24 × 7 availability of trained doctors/skilled birth attendants in health centers, motivating each of the pregnant mothers for institutional delivery, enhancing the acceptability and level of trust among the general population toward outreach health workers, implementing steps to encourage community ownership and participation (like maternal and newborn health champions initiatives in Africa, Asia, and Caribbean nations), fostering linkages with nongovernmental organizations to expand the reach of services, conducting evaluation of the existing services to bring about desired modifications, and establishing research priorities to improve global newborn health.[1],[3],[4],[5],[6]

To conclude, to improve the newborn health and survival rates in low-resource settings, the key is to comprehensively improve the quality of care, long before pregnancy, preferably from childhood and adolescent phase, and continuing the same through the pregnancy, childbirth, and neonatal period.

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Conflicts of interest

There are no conflicts of interest.


1World Health Organization. Newborns: Reducing Mortality – Fact Sheet; 2016. Available from: [Last accessed on 2016 Jan 13].
2WHO/UNICEF. Joint Statement. Home visits for the newborn child-A strategy to improve survival. Geneva: WHO Press; 2009. p. 1-7.
3Lunze K, Higgins-Steele A, Simen-Kapeu A, Vesel L, Kim J, Dickson K, et al. Innovative approaches for improving maternal and newborn health – A landscape analysis. BMC Pregnancy Childbirth 2015;15:337.
4Singh D, Cumming R, Negin J. Acceptability and trust of community health workers offering maternal and newborn health education in rural Uganda. Health Educ Res 2015;30:947-58.
5Yoshida S, Martines J, Lawn JE, Wall S, Souza JP, Rudan I, et al. Setting research priorities to improve global newborn health and prevent stillbirths by 2025. J Glob Health 2016;6:010508.
6Dao B, Otolorin E, Gomez PP, Carr C, Sanghvi H. Preparing the next generation of maternal and newborn health leaders: The maternal and newborn health champions initiatives. Int J Gynaecol Obstet 2015;130 Suppl 2:S40-5.