The Neonatal Rescue Scheme (NRS) concept reduces mortality by over 85% in Niger State Nigeria – A lesson for Nigeria and other LMICs

Abstract

Nigeria is well-known for its extremely high neonatal mortality rate, putting the country at the top of the list of most needy LMICs. Daily, over 846 babies die from preventable reasons across the constituent States in Nigeria. The Niger State, located at the northwest of the middle belt, had one of the highest neonatal mortality rates prior to 2017. All Nigerian States habitually rely on federal government health centres for the special care of their growing population of needy neonates. Only one such centre is in the State of Niger, yet there has been no significant progress in the entire State. This resulted in the State government taking on an extraordinary step of independently trialing the new concept of a Neonatal Rescue Scheme (NRS), powered by LMIC-compatible frugal neonatal devices and procedures.The Amina-centre, so-commissioned in 2017, has sustainably used indigenous basic medical officers and nurses who received prior short-term training on the applications of the NRS to deliver impactful services to neonates. This 6-year impact and comparative assessment study explored how the services of the Amina-centre have radically transformed the Niger State's desperate situation by reducing the facility mortality from 90/100 neonates to 4/100 neonates. This innovative program also attracted and increased the average neonatal traffic from 20 neonates/month to an astronomical 264 neonates/month. The Amina-centre represents a typical transformation that could alleviate many precarious neonatal healthcare problems in every LMIC setting.