Last month, the Baby Hero team was fortunate to have Dr. Shaun Morris visit Hong Kong. A pediatric infectious disease specialist at The Hospital for Sick Children (SickKids) in Toronto, Canada, he, together with his colleague Dr. Lisa Pell, is our partner in fighting infant mortality. Dr. Morris developed the Newborn Survival Kit (NSK), which contains critical supplies to help women in low income countries deliver their babies in a safe and hygienic way and to improve health outcomes in the first month of life. During his visit, Dr. Morris updated us on the progress of the Newborn Kit.
How close are we to understanding the impact of the NSK?
Over the past year and a half, the Newborn Survival Kit has been part of a controlled field study to monitor its impact. The study was carried out in the Rahim Yar Khan district of Pakistan, roughly 700 kilometers northeast of Karachi. In this district, about half of all women give birth at home, and it’s estimated that 1 out of every 25 newborns will die in their first 28 days of life.
Data collection from the field is near completion. 150 villages and their associated LHWs participated in the study and were randomized into one of two groups – newborn kit or standard of care. About half the women in the study received a Newborn Survival Kits along with education about its use during their 3rd trimester of pregnancy, while the other half received the normal standard of care for Rahim Yar Khan. Data collectors aimed to visit mothers and newborns at home five times in the first four weeks after delivery – on days of life 1, 3, 7, 14, and 28. The data from these visits is now being evaluated in Toronto. Results from the data analysis are expected in Spring 2017. Preliminary evaluations suggest that when used correctly, the NSK does reduce newborn mortality. The team is now quantifying the effectiveness of the NSK and trying to understand in what sub-populations it works best.
What happens after the study is completed?
If the data reveals a significant reduction in newborn mortality, as we anticipate, the next step will be a scale-up of the NSK. So far, about 6,000 NSKs have been distributed in Pakistan and Kenya, of which 4,393 were partially funded by Baby Hero. After the completion of the study, the aim is to potentially distribute up to 100,000 Newborn Kits in Pakistan.
Through scale-up, Dr. Morris and Dr. Pell hope to reduce the production and assembly cost of the NSK to make it an even more cost-effective solution to reducing newborn mortality. During the data evaluation, they hope to identify the most and least effective parts of the Newborn Kits, the most and least used parts of the kit, and to re-evaluate the composition and necessity of each component. Ideally, all products should be produced and assembled in Pakistan, to reduce costs and support the local economy.
Data collectors being trained
What would scale-up look like?
The ultimate goal is to give the NSK a life of its own, to make it a part of the care available to families in rural low-income areas, giving them the tools necessary to save the lives of their children and improve their health.
It will be important to eventually develop an automated distribution network that will allow soon-to-be mothers access to the Newborn Survival Kit when needed even if outside the context of a study. The Lady Health Workers, who played an important part in the newborn kit study by educating pregnant women on how to use the Newborn Survival Kits, may also be the key to a more independent and continuous distribution of the NSK post-study. The Lady Health Worker program exists throughout most of Pakistan, meaning a potential delivery mechanism for the intervention is already largely in place nation-wide.
We are looking forward to getting the official study results in the next few months and working with Drs. Morris and Pell on the scale-up of this potentially game-changing solution for newborn health in the developing world.
The Baby Hero Team and Interns with Dr. Shaun Morris in HK