Focus on interventions for SSNB

Basic Thermal Care, Big Impact: Reducing Newborn Hypothermia with Low-Cost Interventions in Delivery Rooms at Neno District Hospital-Malawi. This was a Quality improvement project aimed at reducing hypothermia upon admission to NICU among inborn babies. Process indicators (delivery room temperatures, newborn drying towels and intact closing windows and doors, functionality of radiant/dream warmers were tracked in the delivery rooms including major operating theatre. Whilst outcome indicator (hypothermia upon admission) was being tracked at neonatal nursery ward. Multidisciplinary data review meetings involving the biomedical team were conducted bi-weekly. The hypothermia was successfully reduced from 72% to 23% within the six months of the project implementation.

Neonatal mortality due to prematurity remains a major challenge in Rwanda, with apnea of prematurity (AOP) as a key contributor. To address this, the Ministry of Health partnered with CHAI to pilot the introduction of caffeine citrate (the global first-line treatment for AOP) in 10 high-burden hospitals covering over 20% of preterm admissions. The initiative included commodity distribution, provider training, and integration into national health systems, including updating the Essential Medicines List and procurement plans. Early results from the pilot show a 17% reduction in neonatal mortality over 10 months and improved provider confidence due to CC's safety and tolerability. National efforts have initiated negotiations for price reductions and ongoing engagement with the National Health Insurance Scheme to ensure equitable access. Rwanda's experience highlights the importance of government leadership, collaboration, and system planning to successfully introduce life-saving interventions in resource-limited settings.

Human milk banking can expand access to human milk for small and vulnerable newborns, yet many LMIC hospitals lack end to end systems. This session shares how two tertiary hospitals in Uttar Pradesh, India strengthened Comprehensive Lactation Management Centres through a quality improvement approach embedded within the LIFT UP implementation research. The pre existing milk banks functioned suboptimally; a Feeding Support Plus package for improving lactation and feeding of mother's own milk for small vulnerable newborns included breastmilk expression, counseling, and hygiene protocols created a donation pipeline. Milk donations improved 150% and 294% in the two facilities. Practical changes included mother to mother counseling , grief sensitive support for bereaved mothers, strengthened workflows to prevent contamination. These low cost, scalable adaptations offer a replicable model for low and middle income countries to expand safe human milk access for preterm and low birth weight newborns, addressing critical gaps in neonatal