Newborn Device Planning and Costing Tool: Systematic Tool Development to Inform Scale-Up of Small and Sick Newborn Care in Low-Resource Settings

High-quality neonatal care, a marker of health system function, is dependent on functional medical devices, with context-specific specifications, adequate numbers, and ongoing maintenance. Devices designed for high-income settings may break, lack consumables, or be unused. Currently, systematic tools for device planning and costing that allow health system managers to utilize data to allocate budgets and mobilize resources at district and/or national levels are lacking. To close this gap, we developed a tool to support countries working towards Every Newborn targets for scale-up of World Health Organization (WHO) level 2 neonatal care.

Culture Gap: Antibiotic Versus Blood Culture Use for 61 Facilities with NEST360 in Kenya, Malawi, Nigeria, and Tanzania 

Thirty million small and sick newborns require admission annually, many being prescribed antibiotics without blood cultures, the current "gold standard" for neonatal infection detection. Low neonatal blood culture use hampers antibiotic stewardship, fueling antimicrobial resistance (AMR), which threatens newborn survival. This study analyzes the gap between blood culture use and antibiotic prescribing for newborns admitted to facilities implementing Newborn Essential Solutions and Technologies (NEST360) in Malawi, Kenya, Tanzania, and Nigeria.

Target Product Profiles for Neonatal Care Devices: Systematic Development and Results with NEST360 and the United Nations Children's Fund (UNICEF) 

Medical devices are critical to provide high-quality, hospital-based newborn care. Many devices available in high-income countries are not available in low- and middle-income countries (LMICs) because they are not designed for these settings. This gap could be filled by medical devices designed specifically for LMIC settings. Target product profiles (TPPs) are developed early in the medical device development process to define the setting, target user, and range of performance characteristics.

Digitization and Adaptation of the World Health Organization (WHO) Integrated Management of Newborn and Childhood Illness for an Electronic Clinical Decision Support Tool for Sick Young Infants 

Adherence to evidence-based clinical guidelines is poor in many low- and middle-income countries (LMICs), obstructing progress in ending preventable newborn and young infant deaths. Electronic clinical decision support algorithms (CDSA) have improved care quality for older children, but few have been tested for young infants. We developed digital adaptations of evidence-based guidelines for implementation research of CDSA, with and without point-of-care diagnostics, to improve appropriate management of sick young infants.