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Current Pediatric Research| Volume: 22
November 28-29, 2018 | Dubai, UAE
15
th
World Congress on
Pediatrics, Clinical Pediatrics and Nutrition
28
th
International Conference on
Nursing Practice
Joint Event
&
Sustainable neonatal mortality reduction in a low-income setting is doomed if appropriate local
technologies are neglected-A 22-years’ lesson
Hippolite O Amadi
Imperial College London, United Kingdom
G
eneral management of immediate needs of newborn
babies for survival is not foreign to any culture in the
world. A low-income country can be likened to a low-income
household that may not have enough money to buy-in quality
food; hence, for sustainable supply of good quality food,
the family must not neglect growing possible foods within
the home garden. International technology market is full of
expensive foreign ideas that have drawn away the attention
of low-income setting dwellers (LISD) from focusing on their
improvable local technologies. LISDs are unable to buy sufficient
number of these foreign technologies (FTs) to support their vast
national requirements; they are unable to find sufficient funds
to sustain the required expensive maintenance. Hence systems
soon breakdown, neonatal mortality rate soars and they are
back to the same old pressure. This is the vicious-cycle that has
bedevilled some LISDs of the world and fairly responsible for
their inability to achieve the MDG4 target in 25 years. Local-
content inspired technologies (LCTs) are cheaper alternatives,
locally available and maintainable by locals, easily produced
in adequate quantities and can locally be improved upon as
need demands. The 22-years’ experience of our research group
has allowed a comparative analyses of neonatal outcomes
between unsustainable dependence on FTs and unattractive
but sustainable application of LCTs in Nigeria. We used over
ten neonatal centres covering all regions of Nigeria to study
and devise LCTs for neonatal care. The LCTs were applied at our
few centres while the FTs were practiced at the rest of Nigeria’s
neonatal centres during the last ten years of MDG4. Our LCTs
included, amongst others: (1) the recycled incubator technology
to create affordable alternative for incubator intervention, (2)
definitionofclimate-inducedneonatal‘evening-feversyndrome’
(EFS) and synthesis of a nursery-building pattern that lowers
climatic harsh impact on neonates, (3) the Handy-approach and
initial-setpoint-algorithm temperature protocols that enabled
patient-specific interactive technique for neonatal normotherm,
(4) a low-cost Politeheart bubble-CPAP machine for neonatal
respiratory support, etc. Our innovative applications ensured
consistent availability of up to 18 LCTs functional incubators on
national average as compared to average of 3 FTs at the end of
MDG4. Early neonatal mortality for ELBW reduced by 80% for
LCTs centres as compared to <1% at FTs centres; overall average
facility-based NNMR reduced to 31/1000 at LCTs centres as
against 245/1000 at LTs centres. Nigeria was unable to score
any significant reduction in neonatal mortality during MDG4
let alone sustaining any gains as these were based on locally
hard-to-sustain technologies at the Nigerian centres. LCTs could
have provided the much needed reduction at a national scale
if these were embraced. The world must encourage every low-
income country to creatively innovate and improve on own
local technologies to boost sustainable high survival rates.
e
:h.amadi@imperial.ac.ukPediatrics and Clinical Pediatrics 2018
& Nursing Practice 2018, Volume 22
DOI: 10.4066/0971-9032-C2-006