Systematic scaling up of neonatal care in countries

Rudolf Knippenberg, Joy E. Lawn, Gary L. Darmstadt, Genevieve Begkoyian, Helga Fogstad, Netsanet Walelign, Vinod K. Paul

Research output: Contribution to journalArticle

Abstract

Every year about 70% of neonatal deaths (almost 3 million) happen because effective yet simple interventions do not reach those most in need. Coverage of interventions is low, progress in scaling up is slow, and inequity is high, especially for skilled clinical interventions. Situations vary between and within countries, and there is no single solution to saving lives of newborn babies. To scale up neonatal care, two interlinked processes are required: a systematic, data-driven decision-making process, and a participatory, rights-based policy process. The first step is to assess the situation and create a policy environment conducive to neonatal health. The next step is to achieve optimum care of newborn infants within health system constraints; in the absence of strong clinical services, programmes can start with family and community care and outreach services. Addressing missed opportunities within the limitations of health systems, and integrating care of newborn children into existing programmes - eg, safe motherhood and integrated management of child survival initiatives - reduces deaths at a low marginal cost. Scaling up of clinical care is a challenge but necessary if maximum effect and equity are to be achieved in neonatal health, and maternal deaths are to be reduced. This step involves systematically strengthening supply of, and demand for, services. Such a phased programmatic implementation builds momentum by reaching achievable targets early on, while building stronger health systems over the longer term. Purposeful orientation towards the poor is vital. Monitoring progress and effect is essential to refining strategies. National aims to reduce neonatal deaths should be set, and interventions incorporated into national plans and existing programmes.

Original languageEnglish (US)
Pages (from-to)1087-1098
Number of pages12
JournalThe Lancet
Volume365
Issue number9464
DOIs
StatePublished - Mar 19 2005

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Newborn Infant
Community-Institutional Relations
Maternal Death
Health
Child Care
Decision Making
Costs and Cost Analysis
Infant Health
Perinatal Death

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Knippenberg, R., Lawn, J. E., Darmstadt, G. L., Begkoyian, G., Fogstad, H., Walelign, N., & Paul, V. K. (2005). Systematic scaling up of neonatal care in countries. The Lancet, 365(9464), 1087-1098. https://doi.org/10.1016/S0140-6736(05)71145-4

Systematic scaling up of neonatal care in countries. / Knippenberg, Rudolf; Lawn, Joy E.; Darmstadt, Gary L.; Begkoyian, Genevieve; Fogstad, Helga; Walelign, Netsanet; Paul, Vinod K.

In: The Lancet, Vol. 365, No. 9464, 19.03.2005, p. 1087-1098.

Research output: Contribution to journalArticle

Knippenberg, R, Lawn, JE, Darmstadt, GL, Begkoyian, G, Fogstad, H, Walelign, N & Paul, VK 2005, 'Systematic scaling up of neonatal care in countries', The Lancet, vol. 365, no. 9464, pp. 1087-1098. https://doi.org/10.1016/S0140-6736(05)71145-4
Knippenberg R, Lawn JE, Darmstadt GL, Begkoyian G, Fogstad H, Walelign N et al. Systematic scaling up of neonatal care in countries. The Lancet. 2005 Mar 19;365(9464):1087-1098. https://doi.org/10.1016/S0140-6736(05)71145-4
Knippenberg, Rudolf ; Lawn, Joy E. ; Darmstadt, Gary L. ; Begkoyian, Genevieve ; Fogstad, Helga ; Walelign, Netsanet ; Paul, Vinod K. / Systematic scaling up of neonatal care in countries. In: The Lancet. 2005 ; Vol. 365, No. 9464. pp. 1087-1098.
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