Neonatal mortality has stagnated and 70% of neonatal deaths occur in low birth weight babies. The Every Newborn Action Plan 2020-2025 set a target of a functional inpatient special care newborn unit (SNCUs) to care for small and sick newborns in at least 80% of districts. Most GFF countries have endorsed the ENAP targets, yet the requirements to meet this target are not well understood. SNCUs need to be able to provide oxygen and other breathing support, KMC, and should ensure that the mother and baby are not separated during care.
Many countries around the world have or are in the process of adopting standards and guidelines to ensure the scale-up delivers good quality newborn care. However, many face the challenge of unpacking ‘what it takes’ and how much it would cost to fulfill the system requirements of that quality of care standards. And without clear and costed guidance there will be small and sick newborn care units that are ad hoc adaptations in facilities that do not meet quality standards and will not reduce NMR
We are presenting a costing tool developed by GFF to support this exercise and the results of a pilot undertaken in Zambia in late 2022. The costing exercise in Zambia created opportunities for reviewing and clarifying country standards, such as required staff and equipment. It also facilitated discussions about the quality of care strategies beyond the facility level, such as referral systems and pre-service training, that are critical for a successful scale-up.
The exercise also showed that notwithstanding pre-conceived notions of upfront investments greater than ongoing costs, recurrent expenditures associated with human resources and equipment-related costs are substantial.
We want to share what we have learned in Zambia and explore where this might be of value in other countries.
