Abstract:
Surviving prematurity poses the greatest challenge in neonatal care in low- to middle-income countries (LMICs). South Africa has not
made much progress in improving the survival of preterm babies. Neonatal survival of preterm infants has become a national priority
since the serious failure to reach the Millennium Development Goal targets in 2015. High rates of prevention are particularly relevant in
LMICs, where the neonatal mortality rate is at its highest owing to a lack of simple and effective measures. Preventing prematurity and
related complications begins with a healthy pregnancy. Antenatal care and maternal corticosteroids are antenatal interventions that could
improve the survival of preterm babies. Postnatal interventions include: the management of neonatal sepsis, meningitis and pneumonia;
prevention of hypothermia after delivery, for example, the plastic bag/wrap and cap, which has been extensively researched and is found
to be an effective, low-cost method for reducing hypothermia in preterm infants; the use of continuous positive airway pressure (CPAP),
including the low-cost CPAP device, which is a cost-effective strategy for providing respiratory support for premature neonates with
respiratory distress syndrome; exogenous surfactant; early feeding with breastmilk; and kangaroo mother care. The use of cost-effective,
evidence-based interventions can be implemented in LMICs to reduce neonatal mortality.
