TABLE 3.

Impact of ANCS and Other WHO-Recommended Interventionsa to Prevent Preterm Mortality From RDS, IVH, and NEC, Sub-Saharan Africa, 2015

Scenario No.ScenarioIncremental Change ModelbUniversal Coverage Modelc
Preterm Deaths, No.dPreterm Deaths Prevented Compared With Current Level of Care, No. (%)Preterm Deaths, No.Preterm Deaths Prevented Compared With Current Level of Care, No. (%)
1Current levels of prevention, diagnosis, and treatment303,400N/A303,400N/A
Improved WHO single interventions
2Increased surfactant in hospital settings for RDS303,300100 (<0.1)303,100300 (0.1)
3Increased ANCS in hospital settings for RDS, IVH, and NEC302,3001,100 (0.4)298,4005,000 (1.7)
4Increased oxygen/CPAP in hospital and clinical settings for RDS295,3008,100 (2.7)261,10042,300 (13.9)
Improved diagnosis of preterm labor and transfer with current care
5Increased diagnosis of preterm labor birth, with current levels of care for RDS, IVH, and NEC302,4001,000 (0.3)299,9003,500 (1.2)
6Increased diagnosis of imminent preterm birth and transfer to hospitals, with current levels of care for RDS, IVH, and NEC301,3002,100 (0.7)287,10016,300 (5.4)
Improved diagnosis and transfer with WHO single interventions
7Increased diagnosis of respiratory distress, transfer, and surfactant (hospitals only) for RDS299,9003,500 (1.2)282,80020,600 (6.8)
8Increased diagnosis of imminent preterm birth, transfer to hospitals, and ANCS (hospitals only) for RDS, IVH, and NEC298,6004,800 (1.6)236,70066,700 (22.0)
9Increased diagnosis of respiratory distress, transfer, and oxygen/CPAP for preterm RDS287,40016,000 (5.3)176,100127,300 (42.0)
Improved diagnosis and transfer with WHO packaged interventions
10Improved diagnosis of imminent preterm birth, transfer to hospitals, ANCS (hospitals only), and treatment with surfactants (hospitals only) and oxygen/CPAP for RDS, IVH, and NEC289,70013,700 (4.5)191,300112,100 (37.0)
11Increased diagnosis of respiratory distress, transfer to hospitals, and treatment, including surfactants (hospitals only) and oxygen/CPAP for RDS286,90016,500 (5.4)155,700147,711 (48.7)
12Hospital delivery for all preterm birth, with ANCS (hospitals only), improved diagnosis and treatment of respiratory distress, including surfactants (hospitals only) and CPAP for RDS, IVH, and NEC223,30080,100 (26.4)112,800190,600(62.8)
  • Abbreviations: ANCS, antenatal corticosteroids; CPAP, continuous positive airway pressure; IVH, intraventricular hemorrhage; NEC, necrotizing enterocolitis; RDS, respiratory distress syndrome; 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.