The Newborn Essential Solutions and Technologies (NEST360) international alliance today launches Phase 2 of its groundbreaking mission to reduce newborn mortality in sub-Saharan Africa with $65 million in funding from the Bill & Melinda Gates Foundation, the Children's Investment Fund Foundation, The ELMA Foundation, and generous individual contributions.
(Photo by Jeff Fitlow/Rice University)
Of the estimated 2.3 million newborns who die every year around the globe mostly from preventable causes, African countries have the highest rates of mortality. An African newborn has almost 10-times the risk of neonataldeath compared to a baby born in Europe or the U.S. Adequate medical care could ensure the survival of 75% of the estimated 1.1 million African newborns who die each year. By focusing on sub-Saharan Africa, the NEST360 mission is strategically aligned with the United Nations' 2030 Sustainable Development Goals (SDG), specifically targeting SDG 3.2, the goal to limit newborn deaths to no more than 12 per 1000 live births by 2030.
"NEST360 is an international alliance of clinical, biomedical, and public health experts from 22 leading institutions and organizations," said NEST360 co-founder Rebecca Richards-Kortum, a bioengineering professor at Rice University. "Improving quality for small and sick newborn care in NEST360-implementing countries and beyond requires a systems-change approach that cuts across all levels of care.
"This includes addressing the multiple clinical needs of the individual patient; ensuring the design, availability, and maintenance of appropriate equipment and sufficient clinical and biomedical staff at facilities across a district; and implementing national policies to support overall care."
This second, five year phase of the initiative will build upon the progress achieved in Malawi, Tanzania, Kenya, and Nigeria during the initial phase (2019-2023), where the alliance, in partnership with the countries' governments, improved the quality of care for about 100,000 babies admitted each year to the 67 hospitals implementing NEST360.
With a target fundraising goal of $90 million, this next phase will impact five key countries that together contribute to almost 50% of the newborn deaths on the continent. In Phase 2, the alliance's reach will grow to 144 implementing hospitals, with expansion of the network to Ethiopia.
Newborns face very different chances of survival around the world, simply due to where they were born. Small and sick babies are especially vulnerable, as they can require around-the-clock care involving more than one medical device or procedures to sustain vital functions like breathing, thermoregulation, or to fight infection. Nearly half of all childhood deaths occur during the first four weeks of life, with the riskiest day being the first day after birth.
"I firmly believe that together, we can and must make this possible," said NEST360 co-founder Dr. Queen Dube, Newborn Health Program Lead of the Department for Maternal, Newborn, Child, Adolescent Health and Aging at the World Health Organization. "What makes NEST360 unique is that they co-design a package of care with African governments to implement and improve newborn survival in their front-line hospitals."
A collaborative effort of organizations based in Africa, the U.S., and the U.K., the alliance takes a strategic data-driven approach to improving newborn care in sub-Saharan Africa.
"Most approaches to small and sick newborn care have focused on single interventions, but most newborns will have more than one problem and, therefore, require multiple interventions," said NEST360 co-founder Dr. Nahya Salim, a clinical pediatric specialist at the Muhimbili University of Health and Allied Sciences. "As a clinician, I have learned firsthand how important it is to have the right space, the right devices, adequately trained staff, and locally owned data to ensure every newborn can arrive, survive, and thrive."
NEST360 focuses on three critical pillars to ensure implementation of a health systems package that encompasses not only the provision of life-saving equipment but also effective utilization and integration for sustainability:
1. Delivering Innovation: NEST360 deploys effective medical technologies suitable for low-resource settings. The aim is to identify existing devices for effective, rugged, and affordable use in these environments and, where needed, to accelerate the creation and scale of new solutions. Rice360 Institute for Global Health Technologies is dedicated to advancing technologies for global health and is a critical partner working on this pillar.
2. Establishing an Educational Ecosystem: NEST360 trains health care providers, including nurses, doctors, and biomedical technicians, in the operation, maintenance, and repair of critical newborn care technologies, working to integrate these skills into national curriculums for a sustainable health care workforce. The initiative has developed open-source educational resources, hands-on training programs for clinicians and biomedical engineers, and has established a unique cross-country model for sustainable impact.
3. Implementing Evidence-Based Care: A key to sustainable impact, this pillar involves data-driven approaches for improving quality of care and governmental buy-in. Monitoring and evaluation are crucial for identifying strengths and areas for immediate improvement, as well as for documenting a performance track record that can serve as a blueprint for implementing the NEST360 action model in other contexts/regions.
Having achieved coverage across all districts in Malawi during the initial phase of the program, the initiative's 77 new sites in Phase 2 are planned in Tanzania, Nigeria, Kenya, and Ethiopia ⎯ the latter being the most recent NEST360 partnering nation. The alliance's expansion into Ethiopia builds on an existing national-level initiative, Saving Little Lives. NEST360's robust network of stakeholders and its collaborative approach with African governments support sustainable, country-led change.
"Over the last five years, NEST360 has accomplished the seemingly impossible while ensuring that change is being led from within each country. We are excited to be a part of this program for the next five years and to see the positive outcomes that will outlive NEST360," said Dr. Minnie Kibore , senior manager for Child Health and Development at the Children's Investment Fund Foundation. Kibore spoke on behalf of the NEST360 Funding Coordinating Committee, comprised of the Bill & Melinda Gates Foundation, the Children's Investment Fund Foundation and The ELMA Foundation.
"I am inspired by the transformative impact of the NEST360 international alliance. The commitment to reducing newborn mortality in sub-Saharan Africa through innovative solutions, strategic collaboration and a data-driven approach exemplifies the best of global health initiatives," said Rice University President Reginald DesRoches. "The expansion of the NEST360 program reflects a profound dedication to systemic change, addressing not only the clinical needs of individual patients but also the crucial aspects of equipment availability, healthcare staff, and national policies.
"This initiative aligns with the core values of our university, emphasizing the role of education, research and innovation and evidence-based care in creating sustainable improvements in newborn health."
