Worldwide, forty percent of childhood deaths occur in the first four weeks of life and global progress to improve newborn survival has been frustratingly slow. At current rates of progress, it will be 150 years before a baby born in Africa has the same chance of survival as one born in North America.
While African child mortality has been greatly reduced through vaccines and other solutions, sub-Saharan Africa (SSA) has lagged greatly behind most other parts of the world in lowering newborn mortality. The vast majority of African newborn deaths are preventable and one piece missing is access to life-saving medical technologies. In many low-resource settings, the tools to care for neonates are comparable to what was available in the US in the 1950s.
Well-meaning donors have tried to fill this gap by giving equipment. These gestures result in “equipment graveyards”— piles of expensive technologies that are effective in a high-resource setting but fail in Africa due to harsh environments, complex maintenance requirements, or inconsistent electricity.
Shown below is a shot taken of such a graveyard at our partner hospital in Malawi. Without new approaches, including a focus on developing complementary education and entrepreneurial capacity, existing global inequities in neonatal outcomes will persist. These needs are not currently served by the private sector, which perceives significant investment risk.
Newborn mortality per 1000 births in various parts of world.
Causes of Newborn Deaths in Africa
NEST was born from our desire to build a platform that will reduce newborn mortality rates nations across the world, not just in Africa. To us a nest is a powerful symbol of the preparation for birth, built for safety and nurturing, and the launching pad for a healthy life.
It is a universal, cross-cultural symbol that can be used wherever and whenever the need exists. It represents hope and the promise of generations to come. Importantly, nests appear everywhere, in all shapes, constructed of all kinds of materials, existing in the harshest of environments or the most serene places. This ubiquity speaks to the tenacity and scalability of our concepts.
We want our NEST package to similarly be a source of hope and future possibilities for newborns, families, and healthcare staff across the globe.
We often get asked:
Can this really be done?
We discussed NEST with clinicians across Africa. As we entered one newborn unit, we were met by a clerk rushing out with a stack of death certificates. On that ward, during a 45 minute visit, we witnessed the death of two babies – both would likely have survived if the hospital had NEST. None of us will forget that visit; we will dedicate our careers to ensuring that a baby born in Africa has the same chance of survival as one born in North America.
In the 1990s, AIDS was similarly thought to be an unsolvable problem in Africa. The belief was treatments were too expensive, African health systems were too weak to deliver them, and some believed that adherence would be impossible to obtain. Yet this was disproved. While the battle against AIDS in Africa is not over, today almost over 17 million people in Africa are accessing life-saving anti-retroviral therapies and death rate from AIDS-related illnesses has dropped >50%. With AIDS, the key to successful scale-up of treatment was to first demonstrate that a solution was possible. Our team is ready to challenge the similar complacency surrounding poor newborn outcomes in Africa. We have a proven solution that is ready to be scaled, is self-sustaining, and will catalyze broader change.