Improved Neonatal Survival Through Economically Sustainable Reorganization of a Neonatal Care Unit in a Developing Country: 7-Year Experience in the Centre Medical Saint Camille (CMSC) of Ouagadougou, Burkina Faso.

Every year approximately 3.7 million neonatal deaths occur worldwide plus an additional 3.3 million stillbirths. Thirty-eight percent of all under 5-year-old deaths are concentrated in the first 28 days of life, 75 % of them in the first 7 days, making the first week the most dangerous period of a lifetime. Sub-Saharan Africa remains the most dangerous region to be born, here 1.16 million babies do not survive more than 28 days and every year, half a million babies die within the first 24 h of life [1]. Just three causes account for 86 % of those deaths: asphyxia, prematurity, and severe infections like tetanus, pneumonia, and diarrhea. In fact, it is estimated that serious infections represent 36 % of all neonatal deaths [2], making hygiene a priority. We here report our experience of 7 years of collaboration with the Neonatal Care Unit of the CMSC of Ouagadougou, Burkina Faso, one of the world’s poorest countries. Over 70 % of the 15.4 million inhabitants of Burkina Faso live below the poverty line. Schooling is sparse and health facilities are scarce [3]. Many people, especially children, are severely malnourished and do not have access to clean water, secure food supply, or medical care [4]. Many of these children die from treatable or even preventable infectious diseases such as diarrhea, pneumonia, malaria, HIV, TB, measles, and tetanus [5]. In 2004, the Center St. Camille comprised a maternity ward where more than 5,000 babies were delivered every year and a Neonatal Care Unit equipped with 12 incubators sent from Italy during the early 1980s. 1,200 babies were admitted each year to these incubators and to an additional 50 neonatal cots (all in one room). Oxygen was available from two 20 L pressure tanks. A small room for invasive procedures was available, and the center had a day-time laboratory and a small X-ray facility. Cardiologists equipped with sonography and fetal sonography were available twice weekly (Figs. 1, 2, 3, 4). Country-wide, the CMSC is the only unit specializing in the care of premature newborns and is known beyond the borders of Burkina Faso. In fact, patients come also from neighboring countries such as Mali, Mauritania, and Sierra Leone. Since 2005, Medicus Mundi Italy, a section of Medicus Mundi International, a Non-Governmental Organization (NGO), officially recognized by the WHO, as a specialized health organization, has an ongoing collaboration with the P. E. Villani (&) A. Beatrice G. Mescoli Dipartimento Materno-Infantile, UO TIN, Neonatologia e Nido, AO ‘‘C.Poma’’, Mantua, Italy e-mail: paoloernesto.villani@aopoma.it