Every year in Ethiopia, more than 300,000 babies are born too soon—less than 37 weeks of gestation[1]. These babies are at increased risk of death, long-term disabilities and ill health later in life. Yet, there are a range of interventions that target women before they are even pregnant and during pregnancy that can prevent preterm birth and, most preterm babies can survive with basic care including drying, warming, immediate and exclusive breastfeeding, hygiene and cord care. Given Ethiopia’s success in reducing deaths among children less than five years old, a higher proportion of under-five deaths are occurring among newborns within the first 28 days of life (29 deaths/1,000 live births[2]). Complications due to preterm birth, infections and breathing difficulties are the top three causes of death among newborns in Ethiopia[3].

To reduce newborn deaths, the Federal Ministry of Health (FMOH) and partners in Ethiopia are working together to implement health care interventions that are known to save lives. Building on the existing primary health care structure in the country, the FMOH is supporting expanded access to care during pregnancy, labor and delivery, and the postnatal period as well as community-based neonatal care, and the initiation of newborn corners in health facilities among other interventions.

In an effort to learn what works better to improve the survival of babies born too soon, the FMOH has partnered with the USAID-funded Every Preemie-SCALE project and St. Paul’s Hospital Millennium Medical College to study the implementation of current preterm birth and low birth weight programs and interventions across the primary health care system. “This is a unique opportunity for Ethiopia to learn from our experience as a country and to strengthen interventions and the health care system for improved newborn health care,” said Dr. Wendmagegn Gezahegn of St. Paul’s Hospital.

This implementation research study will take place in three unique geographic locations of Ethiopia representing an urban setting, an agrarian/settled area and a semi-settled/pastoral area, ensuring representation of the main geographic categories. Dr. Jim Litch, the Research, Evidence and Learning Lead representing the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) on the Every Preemie—SCALE project explained that “Studying these different settings will give us the opportunity to understand gaps in implementation and uniquely characterize what can be done differently to improve outcomes for early and small babies.” Lessons learned will be shared widely in Ethiopia and will be used to inform programming well into the future. At the same time, Ethiopia will share its insights with partners working in other countries to strengthen newborn health programming and interventions.

The work in Ethiopia will complement implementation research supported by Every Preemie in Bangladesh, India and Malawi. Judith McCord, the project’s Senior Director emphasized that “because the project is mandated to explore challenges and solutions for newborn programming, we need to understand what works, and what doesn’t work, to ensure that early/small newborns have the services and interventions they need to survive, and live healthy, productive lives.”

[1] Every Preemie—SCALE, Ethiopia Profile of Preterm and Low Birth Weight Prevention and Care, November 2015.

[2] Central Statistical Agency (CSA) [Ethiopia] and ICF. 2016. Ethiopia Demographic and Health Survey 2016: Key Indicators Report. Addis Ababa, Ethiopia, and Rockville, Maryland, USA. CSA and ICF.

[3] Democratic Republic of Ethiopia Federal Ministry of Health. National Strategy for Newborn and Child Survival in Ethiopia. 2015/16-2019/20. Addis Ababa, Ethiopia.  March 2015.

Every Preemie-SCALE is a five-year project awarded by USAID/Washington to a consortium of partners comprised of Project Concern International (PCI), the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) and the American College of Nurse-Midwives (ACNM). The project is designed to catalyze action for preterm birth and low birth weight across 25 USAID maternal and child health priority countries predominantly in Africa and Asia. Every Preemie is supporting implementation research in Bangladesh, Ethiopia, India and Malawi and is also working in Malawi to improve newborn care vis a vis the recently launched Family-Led Care model. See more on Every Preemie here.