The third installment of the 2010 Health Research Report to Congress is newborn health. Today, we look at USAID’s seminal role in working to focus global attention on the issue of newborn survival as well as its investments in establishing the research foundation for action in this area.
By: Neal Brandes, Health Advisor
USAID works to accelerate innovations through the complete development cycle — out of the labs and through a massive scale-up, into the communities to directly benefit the world’s poor. Our goal is to develop ways to save more lives and reduce the burden of diseases as effectively and efficiently as possible.
Of the estimated 8.8 million children under 5 that die each year – 3.7 million are newborn infants who die within the first four weeks after birth. Up to two-thirds of these deaths can be prevented through existing effective interventions delivered during pregnancy, childbirth and in the first hours, days and week after birth. USAID develops and tests simple, low-cost approaches with the greatest potential to prevent death and treat severe illness in low-resource settings with limited access to quality facility-based care.
A growing body of knowledge has shown that home visits by appropriately trained workers to provide newborn care can significantly reduce neonatal mortality even where health systems are weak. Building on an evidence review, WHO/UNICEF released recommendations in 2009 providing new guidance on the importance of home visits in a baby’s first week of life. USAID is promoting and supporting partner country adoption of these recommendations into national programs, encouraging further investment in this area and assisting with capacity building efforts for health care providers and community cadres providing home-based care.
In countries with high mortality rates and weak health systems, high impact community-based approaches such as diagnosis and treatment of child pneumonia and newborn sepsis must be as accessible when it is needed to the people who stand to benefit the most. Approximately one-third of newborn deaths can be attributed to infections caused by birth in unhygienic conditions. A multi-country trial supported by USAID, in partnership with the Bill & Melinda Gates Foundation’s Save the Children/Saving Newborn Lives program; and WHO, is researching different combinations of oral and intramuscular antibiotic regimens for simplified treatment of newborn sepsis in the community.
Each year, 10 million babies suffer from birth asphyxia; 10 percent of these newborns do not survive. USAID has supported the development and validation of newborn resuscitation training materials and devices used to develop the American Academy of Pediatrics’ Helping Babies Breathe (HBB) training curriculum. The Helping Babies Breathe Global Development Alliance (GDA), a public-private partnership launched by USAID along with several partners, is introducing HBB in multiple countries and offers evidence-based training and technical support on newborn resuscitation and high quality, affordable resuscitation devices to birth attendants in low-resource settings.
USAID is also supporting studies looking at the prevention and treatment of neonatal infections through the application of antiseptic to the newborn cord in parallel with research efforts to determine optimal product packaging; the effectiveness of low-cost resuscitation devices in treating birth asphyxia; and strategies to manage care for low-birth weight children including kangaroo mother care or skin-to-skin care.
A recent article in the Lancet noted USAID’s seminal role in working to focus global attention on the issue of newborn survival as well as its investments in establishing the research foundation for action in this area. Under the President’s Global Health Initiative, USAID will expand investments in game-changing innovation through promotion of research and development. Expanding these programs will mean providing easier access at a single location for a broader set of medical and health interventions. It means focusing more clearly and getting the full package of basic health services out to those people who are most vulnerable because they lack access to any protective care at all.
 Shiffman, Jeremy. Issue attention in global health: the case for newborn survival. Lancet 375: 2045-2049. June 5, 2010.