Host country highlights

This study analysed data on 130,773 newborns admitted to 13 hospitals implementing with NEST360 in Kenya between 2019-2024. We compared characteristics, admission diagnoses, and mortality outcomes between inborn newborns and those referred from other facilities. Referred newborns were more likely to be preterm, have low or very low birth weight, and present with respiratory distress and hypoxia. They were also less likely to be admitted on the first day of life. The unadjusted mortality rate among referred newborns was 290 deaths per 1,000 admissions, compared to 113 per 1,000 among those inborn. This was also shown following multivariate analysis (adjusted OR 2.73). Other factors associated with mortality included extreme prematurity, low birthweight, hypothermia, congenital anomalies, and intrapartum related complications. These findings evidence gaps in referral systems and facility readiness, and support the need for targeted improvements in the care and transport of small and sick newborns in low resource settings.

Mombasa County, facing high maternal mortality rates (160/100,000 live births) and adolescent pregnancy rates (8.7%), partnered with The Challenge Initiative (TCI) to strengthen RMNCH/FP outcomes through scalable, high-impact interventions (HIIs). Since 2021, the county has integrated post-pregnancy family planning (PPFP) into 24 facilities, conducted provider mentorships, held 70 youth-focused outreach events, and implemented data-driven decision-making. Advocacy efforts led to RMNCH/FP budget allocations within county plans. Over 24 months, PPFP uptake rose from 10% to 22%, maternal mortality dropped by 30%, and adolescent contraceptive uptake increased by 54%. The integration of FP/AYSRH HIIs within MNH platforms, supported by strong local ownership and expenditure of over 80% of committed funds, demonstrates measurable health gains. Mombasa’s model showcases how locally led, system-strengthening, and youth-responsive strategies can sustainably improve maternal and newborn outcomes and serve as a scalable blueprint for other counties.

Neonatal nurses in low and middle-income countries often work under high stress due to heavy workloads, limited resources, and challenging environments, which contribute to burnout and communication challenges. This research evaluated the implementation of a communication and emotional competence training course in two public hospital newborn units in Kenya. The course, co-developed with nurse managers, ran over nine months and was integrated into daily workspaces. The course aimed to enhance communication, knowledge, skills, and self-awareness, while fostering respectful interactions among staff and with families. Data were collected through course materials, interviews with trained and non-trained participants, and observations of daily work routines. Data were analyzed thematically using NVivo. The training led to improvements in communication, self-efficacy, and professional identity, with potential long-term benefits for care quality and staff well-being. Despite progress, addressing workforce and resource gaps remains essential for lasting change.