New multi-country analyses on SSNB care

This multi-country study of more than 380,000 neonatal inpatients in 64 hospitals describes service readiness, coverage, and care quality for CPAP, highlighting that both coverage and care quality are critical for improving outcomes for preterm neonates. A novel quality-of-care cascade approach will be presented, which allows for visualisation of CPAP care quality at multiple steps in the care pathway during newborn admissions to drive improvements in care quality.

Reliable electricity is essential for neonatal care, yet power outages remain common in sub-Saharan African hospitals, disrupting critical services. This study analyzed 18 months of voltage monitoring data from 60 hospitals in Malawi, Kenya, Tanzania, and Nigeria. Hospitals had a median of 13 months of data, covering 3,442 hospital-weeks. Power outages occurred in 36.6% of weeks, with the highest frequency in Nigeria (67%) and Malawi (45%). An estimated 1,275 days of powered clinical care were lost, primarily in Nigeria (74.8%) and Malawi (20.8%). Outages were most prolonged in Nigeria (median: 180 minutes). Notably, 12 hospitals (20%) accounted for 82% of the care time lost, indicating a concentrated burden. Electricity disruptions pose a major threat to neonatal care, making power monitoring essential to inform urgent, targeted investments in energy resilience, especially for high-burden hospitals, to ensure continuous care and protect vulnerable newborns' lives.

Immediate Kangaroo Mother Care (iKMC), as recommended by WHO in 2022, involves immediate and continuous skin to skin contact and exclusive breast /breastmilk feeding for preterm and low birth weight (LBW) infants, unless critically ill. This multi country implementation research in Bangladesh, Ethiopia, India, and Nigeria integrates iKMC as a core strategy to strengthen small and sick newborn care (SSNC). The intervention includes transforming special newborn care units (SNCUs) into Mother–Special Newborn Care Units (M SNCUs) to enable 24/7 co management of the mother–baby dyad. Phase 1 employed iterative model optimization through facility co design, staff training, and real time data feedback. By July 2025, over 2,000 infants were enrolled, with average skin to skin contact reaching 12.4 hours/day and iKMC coverage exceeding 80% in several sites. Effective KMC at discharge also improved. These findings support the feasibility and health system integration of iKMC as a transformative strategy.