4. Cost–Effective Strategies for the Excess Burden of Disease in Developing Countries

A hospital-based study from China reports baseline surveillance of 1,722 newborns followed by a two-year prospective assessment of 4,751 newborns, while instituting standardized resuscitation guidelines. Previous traditional resuscitation involved infusing central stimulants plus vitamin C and 50 percent glucose; wiping the baby with alcohol; and pressing the philtrum. Health professionals recognized that asphyxia was the leading cause of neonatal death and the second leading cause of infant death nationally. They also recognized that child survival goals could not be met unless asphyxia was addressed. They developed and implemented an evidence-based neonatal resuscitation program, training staff in using the new guidelines. The early neonatal mortality rate fell significantly—by 66 percent, to 3.4 per 1,000.

Source: Adapted from DCP2, chapter 27.