Dear Neil,
Thank you for drawing attention to the Lancet Commission on the Future of Neonatology. Maybe the title itself raises questions – having launched the Every Newborn Action Plan in 2014, WHO and UNICEF put the focus on improving newborn care, including the care of small and sick newborns, and has subsequently monitored the progress in implementation in countries. For example, India has increased their special care units for small and sick newborns to more than 1200 from less than 20 a decade ago. The specialisation of neonatology whilst very important does focus on the hospital intensive care, rather than the holistic approach of family and community – as you rightly pointed out. A focus on the small percentage of pre-term babies that require this type of intensive care will save some lives, but a far greater number will be saved with interventions such as Kangaroo Mother Care in the community.
Every Newborn Action Plan <https://www.who.int/initiatives/every-newborn-action-plan>
Management of small and sick newborns 9789240010765-eng.pdf <https://iris.who.int/bitstream/handle/10665/334126/9789240010765-eng.pdf...
Effect of community-initiated kangaroo mother care on survival of infants with low birthweight: a randomised controlled trial - The Lancet <https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32223-8/abstract#:~:text=Coverage%20of%20kangaroo%20mother%20care%20remains%20very%20low,level%20is%20a%20promising%20strategy%20to%20increase%20coverage.>
It will be interesting to hear others’ opinions,
Best wishes
Liz
CHIFA profile: Elizabeth Mason is former Director of the Department of Maternal, Newborn, Child and Adolescent Health (MCA) in WHO. She is interested in how to provide quality health services for women and children, and how to extend the health system into the community. She spent 24 years living and working in Zimbabwe and worked across many countries of the African Region. She is a member of the Independent Accountability Panel for Every Woman, Every Child, EWEC, which reports on progress towards the UNSG Global Strategy for Woman, Children and Adolescents. elizabethmason108 AT gmail.com