“So never lose an opportunity of urging a practical beginning, however small, for it is wonderful how often in such matters the mustard-seed germinates and roots itself – by Florence Nightingale.”
1. What inspired you to undertake this research?
My interest in neonatal resuscitation developed during my PhD journey, where I became increasingly concerned about the high rates of neonatal mortality in low-resource settings. I wanted to explore interventions that could make a tangible difference.
As I mentioned during the seminar, “this research… was birthed from when I was doing my PhD… that desire came in to delve deeper to find out that particular phenomenon.”
What stood out to me was the immense potential of neonatal resuscitation. In fact, “neonatal resuscitation happens to be one single most important intervention that, if carried out properly, stands a chance of reducing neonatal mortality by as much as 30%.”
2. Why is the neonatal period so critical?
The neonatal period is the most vulnerable phase of life. A large proportion of under-five mortality occurs within the first month, and a significant percentage within the first 24 hours.
I emphasised that “about 30% of these deaths occur within the first 24 hours after birth… meaning that interventions within this period have significant implications on survival.”
This makes timely and effective clinical intervention absolutely essential.
3. Why did you focus on sub-Saharan Africa?
The burden of neonatal mortality is not evenly distributed. Sub-Saharan Africa bears a disproportionate share.
As I explained, “Africa contributes significantly to neonatal mortality… approximately 60% of global deaths occur in sub- Saharan Africa, and together with Asia, this rises to nearly 90– 95%.”
Focusing on this region allows us to address the problem where the need is greatest and the potential impact is highest.
4. What did your research reveal about educational interventions?
My systematic review showed that educational interventions significantly improve both knowledge and practical skills in neonatal resuscitation.
One consistent observation was that “facilities where nurses are trained… there is normally a decline in the number of neonates that die as a result of avoidable errors or poor training.” This reinforces the idea that education is not theoretical—it has direct, life-saving implications.
5. How strong is the current evidence base?
While the findings are encouraging, the quality of evidence is mixed.
We identified several methodological limitations, including reliance on self-reported data, small sample sizes, and lack of control groups. These issues limit the strength of conclusions and highlight the need for more rigorous research designs.
6. What key gaps did you identify in practice?
One of the most important insights from this work is that training alone is not sufficient without systemic support.
As I noted during the discussion, “the training gaps… will be very difficult to address without the political will of governments.”
There are multiple layers to these gaps:
- Workforce shortages
- High workload and burnout
- Limited access to ongoing training
- Inequities in healthcare delivery
I also pointed out a practical challenge: “someone is working 12 hours and you’re calling them to attend training… they are stressed and may not fully benefit from it.”
7. Are these challenges unique to low-resource settings?
Not entirely. While they are more pronounced in low- and middleincome countries, disparities exist even in developed settings.
I reflected that “even in developed countries like Australia, there are huge gaps… in regional areas where access to maternal and neonatal services is limited.”
This underscores the universal nature of healthcare inequities.
8. How important is it to adapt interventions to local contexts?
This is absolutely critical. One of the limitations I identified was that many interventions were externally developed and not tailored to local realities.
I observed that “there was no adaptation of the main interventions to suit local needs or the reality on ground.”
For interventions to be sustainable and effective, they must be culturally appropriate and context-specific.
9. What role does evidence-based practice play in improving neonatal outcomes?
Evidence-based practice is fundamental. It ensures that interventions are grounded in the best available knowledge and are consistently applied.
As I stated, “putting in place evidence-based interventions… will greatly assist in achieving the Sustainable Development Goals.”
Without evidence-based practice, improvements in care are unlikely to be sustained.
10. What are your key recommendations moving forward?
Based on my findings, I would emphasise the following priorities:
- Strengthening workforce capacity through continuous education
- Standardising neonatal resuscitation training
- Increasing investment and political commitment
- Conducting high-quality, context-specific research
- Supporting ongoing professional development
Ultimately, I believe that “professional development is key knowing more and being able to do more will go a long way in addressing these disparities.”
Final Reflection
From my perspective, improving neonatal outcomes requires more than isolated interventions—it demands a systems approach.
Education plays a central role, but it must be supported by:
- Strong health systems
- Adequate workforce planning
- Contextually relevant policies
If we are to reduce preventable neonatal deaths globally, particularly in high-burden regions, we must invest not only in training but in creating environments where that training can be effectively applied.