Empowering the LMIC hinterlands with compatible technologies for neonatal care – the resilience of a research group

Abstract

Background: High neonatal mortality rate (NMR) in low- and middle-income countries (LMIC) might not be resolved until rural healthcare facilities are empowered with sustainable frugal technologies and procedures. Needed technologies may not rely on cutting-edge systems of the high-income countries (HIC), which require much funding and well-established public infrastructure to thrive. Rather, tailored non-conventional designs that are compatible with the deficiencies at low-income settings must take center stage. Study design: A multistage strategy was designed to identify and resolve the technology and knowledge gaps responsible for high NMR and rural community deficiencies militating against neonatal interventions within the primary healthcare settings in Nigeria. Methods: We concluded many scientific investigations and developed interventions over 25 years period to resolve the various factors militating against neonatal survival in Nigeria. Unconventional ideas relying on solar powered systems and easily available local materials were developed, trialed, and commissioned at various times across 31 tertiary hospitals spanning all regions of Nigeria. Stand-alone studies or solutions-creation, amidst discouraging situations, were individually completed, peer-reviewed, and journal-published. The full package of technologies was finally assembled to launch a community empowerment strategy – the Neonatal Rescue Scheme – to generate integrated proof of concept. Finding: The number of early neonatal deaths and overall NMR drastically reduced at participating centers. Conclusions: This Rescue-Scheme strategy could revolutionize neonatal healthcare in low-income countries and drastically reduce Nigeria’s corporate NMR if properly adopted. Clinical evidence: Recent studies of the Scheme and various combinations of its neonatal technologies have demonstrated significant clinical evidence of NMR-reduction, e.g., overall NMR fell from 90/’00 to 4/’00 as published by Amina-center Minna Nigeria 2023; early mortality fell from 81% to 0% - University of Abuja Teaching Hospital Nigeria 2017, etc.