Impact of WHO-Recommended Interventionsa to Prevent Preterm Mortality From Sepsis, Birth Asphyxia, and Low Birth Weight, Sub-Saharan Africa, 2015
| Scenario No. | Scenario | Incremental Change Modelb | Universal Coverage Modelc | ||
|---|---|---|---|---|---|
| Preterm Deaths, No.d | Preterm Deaths Prevented Compared With Current Level of Care, No. (%) | Preterm Deaths, No. | Preterm Deaths Prevented Compared With Current Level of Care, No. (%) | ||
| 1 | Current levels of prevention, diagnosis, and treatment | 198,400 | N/A | 198,400 | N/A |
| Improved WHO single interventions | |||||
| 2 | Oxygen/CPAP for birth asphyxia in clinics and hospitals | 198,000 | 400 (0.2) | 196,800 | 1,700 (0.9) |
| 3 | PPV for birth asphyxia in all settings | 197,200 | 1,200 (0.6) | 195,100 | 4,200 (2.1) |
| 4 | Drying and stimulation for birth asphyxia in all settings | 196,486 | 1,900 (1.0) | 195,400 | 3,000 (1.5) |
| 5 | Thermal care for LBW, including KMC in all settings and warmers in hospital settings | 196,000 | 2,500 (1.3) | 189,400 | 9,100 (4.6) |
| 6 | Antibiotics for suspected neonatal sepsis in all settings | 192,100 | 6,300 (3.2) | 180,300 | 18,200 (9.1) |
| 7 | Breastfeeding for sepsis and LBW in all settings | 189,300 | 9,100 (4.6) | 168,200 | 30,200 (15.2) |
| 8 | Chlorhexidine for sepsis in home settings and dry cord care in clinical settings | 190,800 | 7,600 (3.8) | 159,900 | 38,500 (19.4) |
| Improved diagnosis and transfer with current care | |||||
| 9 | Diagnosis of birth asphyxia and need for postresuscitation care, with current levels of care | 197,200 | 1,300 (0.7) | 196,500 | 1,900 (1.0) |
| 10 | Diagnosis of birth asphyxia and need for postresuscitation care and improved transfer to hospitals, with current levels of care | 197,000 | 1,400 (0.7) | 196,200 | 2,200 (1.1) |
| 11 | Diagnosis of sepsis, with current levels of care | 194,700 | 3,700 (1.9) | 194,300 | 4,200 (2.1) |
| 12 | Diagnosis of sepsis and transfer to hospitals, with current levels of care | 187,400 | 11,000 (5.5) | 184,100 | 14,300 (7.2) |
| Improved diagnosis and transfer with WHO single treatment interventions | |||||
| 13 | Diagnosis of birth asphyxia and need for postresuscitation care, transfer, and oxygen/CPAP | 196,300 | 2,100 (1.1) | 191,700 | 6,800 (3.4) |
| 14 | Diagnosis of birth asphyxia and need for postresuscitation care, transfer, and positive pressure ventilation | 195,500 | 2,900 (1.5) | 189,800 | 8,600 (4.3) |
| 15 | Diagnosis of sepsis, transfer, and antibiotics for suspected neonatal sepsis | 180,800 | 17,600 (8.9) | 169,800 | 28,600 (14.3) |
| Improved diagnosis and transfer with WHO-packaged interventions | |||||
| 16 | Drying and stimulation, diagnosis of birth asphyxia and need for postresuscitation care, transfer to hospitals, and treatment, including PPV and oxygen/CPAP | 188,057 | 10,400 (5.2) | 172,200 | 26,200 (13.2) |
| 17 | Cord care and breastfeeding, diagnosis of sepsis, transfer, and antibiotics for suspected neonatal sepsis | 169,200 | 29,200 (14.7) | 139,400 | 59,100 (29.8) |
| 18 | Packaged interventions 16 and 17, with increased thermal care and breastfeeding for LBW | 159,300 | 39,100 (19.7) | 104,000 | 94,400 (47.6) |
Abbreviations: CPAP, continuous positive airway pressure; KMC, kangaroo mother care; LBW, low birth weight; PPV, positive pressure ventilation; WHO, World Health Organization.
↵a Assumptions regarding baseline penetration and utilization of interventions including ANCS, surfactant, and CPAP as shown in Table 1. Assumptions regarding diagnostics and transfers found in Table 2.
↵b The incremental change model assumes 20% increase from baseline penetration and utilization.
↵c The universal coverage model assumes 98% penetration and utilization of interventions.
↵d All estimates rounded to nearest 100.