Abstract
Setting: Although neonatal mortality is gradually decreasing worldwide, 98% of neonatal deaths occur in low- and middle-income countries, where hospital care for sick and premature neonates is often unavailable. Médecins Sans Frontières Operational Centre Brussels
(MSF-OCB) managed eight specialised neonatal care units (SNCUs) at district level in low-resource and conflict-affected settings in seven countries.Objective: To assess the performance of the MSF SNCU model across different settings in Africa and Southern Asia, and to describe the
set-up of eight SNCUs, neonate characteristics and clinical outcomes among neonates from 2012 to 2015.Design: Multicentric descriptive study.Results: The MSF SNCU model was characterised by an absence of high-tech equipment and an emphasis on dedicated nursing and medical
care. Focus was on the management of hypothermia, hypoglycaemia, feeding support and early identification/treatment of infection. Overall, 11 970 neonates were admitted, 41% of whom had low birthweight (<2500 g). The main diagnoses were low birthweight, asphyxia and neonatal infections.
Overall mortality was 17%, with consistency across the sites. Chances of survival increased with higher birthweight.Conclusion: The standardised SNCU model was implemented across different contexts and showed in-patient outcomes within acceptable limits. Low-tech medical care for
sick and premature neonates can and should be implemented at district hospital level in low-resource settings.