Experts call for stronger emergency newborn care in Nigeria

The Founder and Chief Executive Officer of Outreach of Hospitals, Dr Efunbo Dosekun, has called for an urgent nationwide scale-up of Comprehensive Emergency Obstetric and Neonatal Care (CEmONC) as Nigeria continues to record high levels of preventable newborn deaths and lifelong disabilities.

Dosekun made the call during a virtual news conference titled How CEmONC Is Reducing Maternal and Newborn Deaths in Nigeria.

She disclosed that Nigeria is among the four worst countries globally in terms of newborn survival, with one in every 25 babies dying shortly after birth.

According to her, when maternal and neonatal deaths are combined, Nigeria ranks second highest in the world.

Dosekun identified sepsis, jaundice, birth asphyxia and prematurity as the leading but largely preventable causes of neonatal mortality in the country, stressing that delays in accessing appropriate care remain a major challenge.

She also warned against the casual handling of newborn jaundice, noting that harmful traditional practices, including exposing babies to direct sunlight, can prove fatal.

“If a baby develops jaundice, you must go to a health facility to check the levels. There are charts that guide doctors on whether the baby needs specialised lights or urgent intervention. If not treated properly, jaundice can progress very fast and lead to brain damage or death,” she said.

On neonatal sepsis, she urged parents and health workers to act swiftly once symptoms appear, explaining that severe infections can quickly overwhelm a newborn’s system if not treated early.

Dosekun also drew attention to birth asphyxia—babies who fail to cry at birth—which she described as a major cause of hypoxic ischaemic encephalopathy (HIE), a condition that results from oxygen deprivation to the brain. 

“When a baby cries at birth, oxygen enters the lungs and triggers critical changes in circulation that help the baby adapt to life outside the womb. If this process goes wrong, the brain is damaged. In severe cases, about 80 per cent of these babies die, and survivors often live with seizures or long-term disabilities,” she explained.

She highlighted the Helping Babies Breathe programme as a proven, low-cost intervention, noting that trained birth attendants can successfully resuscitate most non-breathing babies within the first 60 seconds of life. 

According to her, such training should be made compulsories for all birthing practitioners, including nurses and traditional birth attendants.

Babies who require resuscitation, she added, must be closely monitored at secondary-level hospitals because of risks such as seizures, low calcium levels and other complications.

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Addressing prematurity, Dosekun stressed the importance of quality antenatal and perinatal care, including timely administration of steroids to mothers in preterm labour and ensuring deliveries take place in facilities with functional neonatal units. 

Drawing from over four decades of experience in paediatrics and neonatology, she described newborn care as one of the most demanding areas of medicine, where early referral often makes the difference between life and death. 

While acknowledging efforts by Nigerian paediatricians through professional bodies such as the Paediatric Association of Nigeria (PAN) and the Nigerian Society of Neonatal Medicine, she said the country is still far from meeting its neonatal care needs.

Dosekun admitted that delays occur both at home and within hospitals due to overcrowding, limited bed space and weak referral systems. Using Lagos State as an example, she said neonatal bed capacity remains grossly inadequate for a rapidly growing population, even in major teaching and maternity hospitals.

She also raised concerns about the high cost of neonatal care, describing it as a global reality that Nigeria cannot ignore. 

“Quality care for sick and premature babies is expensive all over the world. We need to be honest about that,” she said.

To address financial barriers, Dosekun disclosed that the Federal Government has expanded its emergency obstetric funding programme to include newborn care under the CEmONC initiative. For the past two years, the programme has covered emergency obstetric services, including caesarean sections, to prevent delays caused by lack of funds. About three months ago, it was extended to neonatal care.

Despite this progress, she noted that the shortage of neonatal beds remains a major obstacle. As a result, the government has launched a pilot programme involving selected private hospitals across different geopolitical zones to complement public facilities.

Dosekun revealed that Outreach Hospital Group, which she runs, has been accredited to provide level two neonatal care under the pilot scheme. In Lagos, vulnerable families can now access emergency newborn care at the group’s Lekki and Festac hospitals, alongside designated federal medical centres.

She described the pilot programme as a learning process aimed at identifying gaps in referral systems, workforce capacity, organisation of care and public awareness before nationwide expansion. However, she observed that uptake has been slow due to limited public awareness that free acute neonatal care is now available.

Commending Lagos State’s investments in maternal and child health, she noted that the establishment of at least 11 Maternal and Child Care Centres (MCCs) has contributed to a significant reduction in maternal deaths. Nevertheless, she cautioned that teaching hospitals remain congested and cannot be the sole destination for critically ill newborns.

“To make emergency maternal and newborn care work, we need strong middle-level hospitals. Primary, secondary and tertiary care must work together. Not every sick baby should end up in a teaching hospital,” she said.

She also called for the development of a coordinated emergency referral and transport system, supported by digital technology, to ensure rapid communication and timely transfer of sick newborns.

“From what we have seen in the last three months, about 80 per cent of babies arrive extremely ill. Even with good emergency care, some cannot be saved, or they survive with disabilities,” she said.

Dosekun further emphasised that the success of the CEmONC programme depends heavily on health education and community awareness. She called on families, traditional birth attendants, grandmothers, religious leaders and community influencers to recognise danger signs such as poor feeding, fever, jaundice, breathing difficulties and failure to cry at birth.

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“This problem is too big for one group to solve alone. If we work together—from the community to the hospitals—and focus on awareness, early referral, training and data, Nigeria can make remarkable progress in reducing newborn deaths and long-term disabilities,” she said.