Preventing Newborn Deaths In Romania And Hungary.

E nding preventable newborn deaths is a top priority under the United Nations’ Sustainable Development Goals for 2030. According to the World Health Organization, two-thirds of newborn deaths can be prevented with simple and affordable solutions, such as neonatal resuscitation and early skin-to-skin contact between mother and newborn. Project HOPE, in cooperation with Project HOPE Germany, supports the delivery of these life-saving interventions in Romania and Hungary through strengthening the countries’ health workforces to deliver essential and emergency newborn care. Despite recent improvements, newborn health indicators in most Eastern European countries continue to lag behind those of their Western European neighbors. According toWorld Bank data, in 2015 the neonatalmortality rate in Romania was more than double the average rate of European Union member states (6.3 and 2.6 deaths per 1,000 live births, respectively). Hungary’s rate also remained high, at 3.5 per 1,000. To address this gap, Project HOPE began implementing theNeonatalMedical Exchange Program in 2005 at the Joan Aurel Sbracea Maternity Hospital in Brasov, which has the largest maternal and neonatal care department in the Transylvania region of Romania. The programhas enhanced the hospital’s capacity to provide high-quality maternal and newborn care through a train-thetrainers (TOT) approach; upgraded the neonatal intensive care unit, obstetrics, operating rooms, and laboratory with essential equipment; and helped develop evidence-based protocols. It also provided the hospital with its first fully equipped neonatal ambulance. Program design ensures long-lasting improvements in newborn health outcomes. The TOT model improves the skills of hospital staffmembers in essential and emergency obstetric and newborn care and provides continuing medical education. The program has established and maintains regional professional networks among health care facilities, which provide valuable opportunities to share best practices and lessons learned. The Brasovmaternity hospital is now a leading education center for all maternity hospitals in the Transylvania region. The program has already had a lifesaving impact at the Brasov hospital: Neonatalmortality rates decreased from 9.6 per 1,000 live births in 2007 to 6.9 in 2012. Based on this success, Project HOPE launched a similar initiative in 2015 at the Earl Esterházy Hospital in Papa, Hungary. This program introduced evidence-based protocols on routine and essential newborn care to the hospital and trained delivery room and nursery staff members on the protocols, using the TOT approach. After one year, new staff members had strong adherence to the new protocols, which has resulted inmore newborns receiving appropriate and timely care in the days immediately following birth. Project HOPE’s work in Romania and Hungary demonstrates the effectiveness of low-cost, evidence-based interventions in improving newborn health outcomes. Investing in the development of a skilled health workforce can be the means of saving countless newborns during their riskiest time of life. ▪