Saving Little Lives—Reducing Preterm and Low-Birth-Weight Mortality

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Neonatology".

Deadline for manuscript submissions: 25 June 2026 | Viewed by 695

Special Issue Editor


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Guest Editor
Department of Paediatrics, Stavanger University Hospital, 4068 Stavanger, Norway
Interests: neonatal global health; immediate kangaroo mother care; neonatal resuscitation; neonatal sepsis; neonatal intensive care

Special Issue Information

Dear Colleagues,

Ethiopia had a neonatal mortality rate of 27 per 1000 live births in 2022 and was off track in its goal to achieve Sustainable Developmental Goal 3.2.2, which is to reduce neonatal mortality to at least 12 per 1000 live births by 2030.

Saving Little Lives (SLL) was a Global Financing Facility-supported program aimed at scaling up evidence-based, life-saving interventions for hospitalized neonates across 290 hospitals in Ethiopia, representing 82% of all Ethiopian hospitals. The program integrated evidence-based clinical interventions, quality improvement cycles, and data-driven decision-making. The SLL program was aimed at achieving 35% reduction in neonatal mortality in implementing facilities by increasing intervention coverage to 80% of eligible newborns, with a focus on preterm or low-birth-weight neonates.

This Special Issue includes 14 manuscripts from the SLL program, demonstrating that large-scale nationwide implementation was feasible and effective amidst health system gaps, armed conflict, the COVID-19 pandemic, and economic inflation. The evidence and innovative approaches presented in this Special Issue can be generalized and contextualized to similar programs in low-and middle-resource settings.

Prof. Dr. Siren Rettedal
Guest Editor

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As stated above, the central purpose of this Special Issue is to present research from the project "Saving Little Lives – Reducing Preterm and Low Birth Weight Mortality", the Guest Editors’ contribution to this Special Issue may be greater than standard Special Issues published by MDPI. Further details on MDPI's Special Issue guidelines can be found here:https://www.mdpi.com/special_issues_guidelines. The Editorial Office and Editor-in-Chief of Children has approved this and MDPI’s standard manuscript editorial processing procedure (https://www.mdpi.com/editorial_process) will be applied to all submissions. As per our standard procedure, Guest Editors are excluded from participating in the editorial process for their submission and/or for submissions from persons with whom a potential conflict of interest may exist. More details on MDPI’s Conflict of Interest policy for reviewers and editors can be found here: https://www.mdpi.com/ethics#_bookmark22.

Keywords

  • saving little lives
  • prematurity
  • low birth weight
  • quality care
  • newborn
  • neonatal intensive care unit

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Published Papers (1 paper)

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Research

15 pages, 567 KB  
Article
Readiness to Provide Neonatal Care Services in 208 Ethiopian Hospitals Prior to Implementation of the Saving Little Lives Program
by Lamesgin Alamineh Endalamaw, Abiy Seifu Estifanos, Araya Abrha Medhanyie, Mekdes Shifeta Argaw, Abebe Gebremaraim Gobezayehu, Abebech Demissie Aredo, Znabu Hadush Kahsay, Hege Langli Ersdal, John Nutting Cranmer, Damen Hailemariam and Siren Irene Rettedal
Children 2026, 13(4), 481; https://doi.org/10.3390/children13040481 - 30 Mar 2026
Viewed by 441
Abstract
Introduction: Despite improved health service accessibility, neonatal mortality in Ethiopia remains high at 33 per 1000 live births. Thus, improving health facilities’ readiness across infrastructure, basic amenities, equipment, medications, laboratory services, Kangaroo Mother Care, infection prevention and control, staffing, and guidelines availability is [...] Read more.
Introduction: Despite improved health service accessibility, neonatal mortality in Ethiopia remains high at 33 per 1000 live births. Thus, improving health facilities’ readiness across infrastructure, basic amenities, equipment, medications, laboratory services, Kangaroo Mother Care, infection prevention and control, staffing, and guidelines availability is critical for improving the quality of neonatal care and survival. Objective: The aim of this study was to evaluate the readiness of Ethiopian hospitals to provide services to small and sick newborns. Methods: This was a cross-sectional study including 208 hospitals across four regions in Ethiopia in 2021–2024, prior to the implementation of the Saving Little Lives program. Data was collected using an adapted World Health Organization’s Service Availability and Readiness Assessment tool and are presented using composite scores. Results: The mean composite readiness score for the 208 hospitals for providing services to small and sick newborns in labour and delivery wards was 59%, with domain-specific scores of 47% for basic amenities, 56% for essential neonatal care, and 74% for newborn resuscitation. Significant variation was seen across hospital levels, and basic amenities were available in 68%, 49%, and 43%, essential neonatal care in 68%, 81%, and 71%, and newborn resuscitation in 68%, 66%, and 50% of referral, general, and primary hospitals, respectively. The mean composite readiness score to provide newborn care in the neonatal care units was 57%. Scores varied by hospital levels, with scores of 73%, 64%, and 50% for referral, general, and primary hospitals, respectively. Domain-specific scores were 63% for basic amenities, 65% for equipment, 67% for medications, 63% for laboratory services, 25% for Kangaroo Mother Care, 68% for infection prevention and control, 55% for staffing, and 51% for guidelines availability. Functional bCPAP machines were available in 14% of labour and delivery wards and in 35% of neonatal care units. Conclusions: There was a substantial gap in readiness to provide care for small and sick newborns, and significant variations across hospital levels. Immediate actions must be taken to address the observed gaps to reach the sustainable development goal of reducing neonatal mortality to at least 12 per 1000 live births by 2030. Full article
(This article belongs to the Special Issue Saving Little Lives—Reducing Preterm and Low-Birth-Weight Mortality)
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