The Blueprint Design: Saving Babies’ Lives

Three hours via motorbike on bumpy, dusty dirt roads gets one mother and her sick newborn to their closest health centre. During rainy season, it might double.

If her newborn is critically ill, it’ll take an additional six hours to reach the nearest hospital providing emergency care. One out of every 40 won’t make it.

That’s the reality in Cambodia’s remote province, Preah Vihear. It’s home to one of the highest neonatal mortality rates in the country – far higher than mortality rates globally.

Just across the border in Thailand, that number changes drastically: one death for every 200 babies born, according to UNICEF. 

how does it compare? a Map of regional neonatal mortality

The first 28 days of life – the neonatal period – is the most vulnerable time for a child’s survival. According to UNICEF, it is estimated that 2.9 million neonates die each year, with one million of these occurring on the first day of life. And while there has been a 47% reduction in deaths in children under five in the past 30 years, that rate hasn’t been seen in neonatal babies. Globally the majority of babies who die in their first 28 days of life are preventable and can be saved through basic treatment and equipment.

Angkor Hospital for Children (AHC) is working to reverse those statistics. The paediatric healthcare organisation developed a programme, called Saving Babies’ Lives, designed to do just that.

The Saving Babies’ Lives (SBL) programme, launched in collaboration with the Ministry of Health and Preah Vihear Provincial Health Department in 2017, aims to improve the level of available neonatal care in Cambodia. SBL focuses on improving the continuum of neonatal care across the entire Preah Vihear healthcare system; in villages, rural health posts and health centres, all the way to the Provincial Referral Hospital.

The programme focuses on teaching simple interventions and techniques to specifically help sick newborns. It isn’t complex or clever; it’s using government guidelines and proven, evidence-based models for improving neonatal healthcare. The goal is to reduce neonatal mortality in the province by one third in five years.

“The main causes of death with newborns in Preah Vihear are neonatal sepsis, birth asphyxiation, and premature complications. These issues can all be easily treated by teaching straightforward procedures and empowering staff. We have already done this successfully at AHC, and now we want to do it throughout Cambodia, and hopefully, internationally.”

Prak Manila, SBL Lead

Sustainability is at SBL’s core. The programme allows health centres and the Preah Vihear Referral Hospital to continue to operate once the programme is complete, allowing AHC to replicate this programme into other provinces of Cambodia, ultimately reducing neonatal mortality countrywide ⁠— and potentially internationally.

“It’s not just a cardboard template. Sure, most babies are born, and most babies die, in the villages. But if we just concentrated on providing basic training in these areas, then where would the most critically ill babies go? So we designed SBL to cover the whole continuum of healthcare in Preah Vihear, from the village all the way up to the Referral Hospital. That way we ensure SBL is a long-term, sustainable, ethical programme.”

Claudia Turner, CEO of AHC

AHC has a formal partnership with the Cambodian Ministry of Health to implement SBL. This includes the work under guidance of the Ministry of Health on a variety of paediatric policies and protocols, and sharing research and data covering paediatric health issues to further support health system strengthening in Cambodia. Having the Ministry of Health support is an important step in implementing a large scale programme like SBL. This ensures the SBL model can act as blueprint for other settings and countries to replicate.

 “SBL wouldn’t work without the partnership with the Ministry of Health. They are very supportive of the programme being replicated. So, confidence is high that we will replicate SBL soon to further provinces in Cambodia and internationally.”

Claudia Turner, CEO of AHC

The Saving Babies Lives Programme has already shown improvement in the overall neonatal service delivery in Preah Vihear Province. Watch Baby Devi’s story, one of the programme’s first success stories. This trend is expected to continue as the programme spreads into further areas of Preah Vihear. By 2020, AHC will have trained over approximately 600 village health workers in Preah Vihear. See the data real-time.

The SBL programme is working to reduce neonatal mortality in Cambodia, by making neonatal care a priority, and by building on our knowledge and experience to improve healthcare in the region for years to come.

“So far, SBL has been a huge success. The buy-in from the healthcare workers at all levels of the programme, from VHSG’s to the Provincial Health Department, has been positive. But there is a lot of work still to be done.”

Prak Manila, SBL Lead

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