EVERY PREEMIE—SCALE is a five-year $9 million USAID Cooperative Agreement
Designed to provide practical, catalytic, and scalable approaches for expanding uptake of preterm birth (PTB) and low birth weight (LBW) interventions in 23 USAID priority countries in Africa and Asia.
Are Preterm and Low Birth Weight Babies Treated as a Priority?
The majority of preterm deaths are preventable with good maternal and newborn care. Recently, we asked ourselves how to determine if the care of preterm and low birthweight babies is prioritized within the countries where we work. How could we arrive at one condensed and easy-to-grasp measure of whether the needs of these vulnerable newborns were being addressed and whether the situation was changing within the reality of continued inconsistencies and inadequacies in maternal and newborn health care?
We decided to look at formal Ministry of Health clinical standards and operating procedures for care of preterm and low birth weight babies at the hospital level. We further decided to concentrate our efforts on the 23 USAID maternal and child health priority countries. These countries represent more than seventy percent of maternal and child deaths globally. To look at the prioritization of preterm and low birth weight newborn care at the country level, we decided to focus on the ten critical elements for preterm care as laid out in the 2015 WHO Recommendations for interventions to improve preterm birth outcomes. Interventions include antenatal corticosteroids, tocolytics, magnesium sulphate, antibiotics for preterm premature rupture of membranes, no antibiotics with intact membranes, vaginal birth preference, Kangaroo Mother Care, continuous positive airway pressure for respiratory distress syndrome, safe oxygen use, and surfactant. We searched relevant documents collected from each of the 23 countries and gave each country a rating, 1 through 10, based on the number of these critical interventions addressed in their national standards and guidelines or other relevant clinical documents. Scores for individual countries ranged from a low 1 in Madagascar and Mali to a high of 6 in Ethiopia, Malawi, Rwanda, and Uganda.
The average number of these ten critical interventions for newborn care among the 23 USAID priority countries was 3.9 – one simple, precise figure that will let us know whether or not the situation of care of preterm and low birthweight babies is improving when we repeat this document review in 2019. USAID recently adapted this indicator as one of their dashboard indicators. For more details on the ten interventions by country, please see Graphic: National Clinical Standards for Care of Preterm Newborns at the Hospital Level, December 2015.
Neonatal mortality rate (2013): The UN Inter-agency Group for Child Mortality Estimation, 2014
% of neonatal deaths due to direct preterm complications (2013): Liu L et al. 2014. Global, regional, and national causes of child mortality in 2000-2013:an updated systematic analysis.The Lancet. doi: 10.1016/S0140-6736(14)61698-6
# of preterm births (2013): Preterm birth rate (2010) from Blencowe H, Cousens S, Oestergaard M, Chou D, Moller AB, Narwal R, Adler A, Garcia CV, Rohde S, Say L, Lawn JE. National, regional and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. The Lancet, June 9 2012, 379(9832): 2162-72. Applied to 2013 live births from UNICEF. 2014. State of the World’s Children 2015. Geneva: UNICEF http://www.data.unicef.org/resources/the-state-of-the-world-s-children-report-2015-statistical-tables
USAID Priority Countries:
Afghanistan, Bangladesh, DR Congo, Ethiopia, Ghana, Haiti, India, Indonesia, Kenya, Liberia, Madagascar, Malawi, Mali, Mozambique, Nepal, Nigeria, Pakistan, Rwanda, Senegal, South Sudan, Tanzania, Uganda, Zambia.
On November 17, 2015, Every Preemie–SCALE launched the Country Profiles for Preterm and Low Birth Weight Prevention and Care for 23 USAID priority countries. View the profiles on the Country Profiles tab, or click here.
Every Preemie—SCALE is active in Bangladesh, Ethiopia, India and Malawi
In Bangladesh, Every Preemie—SCALE is working with the Projahnmo Research Group on implementation research titled Development and Validation of Measures and Statistical Models to Improve Estimation of Gestational Age before […]
There are a variety of partners in Ethiopia working with the Federal Ministry of Health (FMOH) to support priority health sector initiatives. The FMOH has exhibited enormous commitment to improving […]
In June 2014, the Government of India (GOI) published the policy guidelines, Use of Antenatal Corticosteroids in Preterm Labour, (Under Specific Conditions by Auxiliary Nurse Midwives), Operational Guidelines. With the […]
In July 2015 the Malawian Ministry of Health (MOH) and partners celebrated the country’s achievement of Millennium Development Goal 4—Reduce Child Mortality. Despite this remarkable success, neonatal mortality remains high […]
Every Preemie—SCALE is proud to be working with our partners USAID, PCI, GAPPS and ACNM
USAID is the lead U.S. Government agency working to end extreme global poverty and enable resilient, democratic societies to realize their potential. In global health, together with partners, we are […]
For over 35 years, PCI has managed USG grants, contracts, and cooperative agreements with local, national, regional or global scope, including over 20 USAID Child Survival and Health Grants Program […]
The Global Alliance to Prevent Prematurity and Stillbirth, an initiative of Seattle Children’s (GAPPS), collaborates with leading global stakeholders to accelerate progress in maternal, newborn and child health. Worldwide, about […]
As the professional organization of certified nurse-midwives and midwives in the U.S., ACNM has more than three decades of experience strengthening the capacity of midwives and other health care professionals […]
Every Preemie—SCALE in the news
Every Preemie—SCALE is co-convening a new Public Private Partnership for the Prevention of Preterm Birth alongside the March of Dimes and the MDG Health Alliance:
In a powerful statement of support for a new push to prevent preterm birth, more than 50 organizations came together in New York City on February 18th, 2015, to discuss the first public-private partnership to prevent preterm birth, with an initial focus on the three countries where one third of all preterm births and an astounding half of all newborn deaths from preterm complications occur – India, Nigeria and Pakistan…