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Updated: May 8, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
An innovative multipartner research program to address detection, assessment and treatment of neonatal infections in
Shamim Ahmad Qazi1, Steve Wall, Neal Brandes
1Department of Maternal Newborn Child and Adolescent Health, World Health Organization, Geneva, Switzerland. qazis@who.int
Insights
This research aimed to find simple, safe, and effective treatments for severe infant infections closer to home. It generated policy recommendations for managing young infant infections in diverse settings.
Area of Science:
- Global Health
- Pediatric Infectious Diseases
- Health Systems Strengthening
Background:
- Severe infections in young infants are a leading cause of mortality globally.
- Innovative approaches are needed to provide timely and appropriate care, especially in resource-limited settings.
- A multipartner research program focused on delivering care closer to home for sick young infants.
Purpose of the Study:
- To generate evidence for a simple, safe, and effective treatment regimen for young infants with severe infections.
- To identify treatment strategies that can be administered by trained health workers when referral is not feasible.
- To inform policy for managing severe infections in young infants in diverse geographical and cultural contexts.
Main Methods:
- A critical review of published and nonpublished data on community-based management of neonatal sepsis was conducted by an expert panel.
- Research studies were designed to improve diagnostic algorithms and evaluate antibiotic regimens for safety and efficacy.
- Existing community health worker programs were utilized to deliver antibiotic treatment when referral was not possible.
Main Results:
- The research program facilitated innovative studies across various geographical, cultural, and administrative settings.
- Evidence was generated to inform the development of revised guidelines for managing sick young infants.
- The program explored the feasibility of large-scale deployment of antibiotic treatment regimens.
Conclusions:
- The research program successfully generated recommendations for policy regarding the management of severe infections in young infants.
- Innovative research approaches were employed to address critical gaps in care delivery.
- The findings support the integration of community-based management strategies into existing health systems.
Background:
In pursuit of innovative approaches for the management of severe infections in young infants, which is a major cause of mortality, a multipartner research program was conceptualized to provide right care in the right place. The primary objective was to generate evidence and identify a simple, safe and effective treatment regimen for young infants with severe infections that can be provided closer to home by trained health workers where referral is not possible.
Research:
Published and nonpublished data on community-based approaches for the management of neonatal sepsis were critically reviewed by an independent expert panel convened in 2007 by the World Health Organization in collaboration with the United States Agency for International Development and Save the Children/Saving Newborn Lives. These stakeholders agreed to 1) undertake research to improve the specificity of a diagnostic algorithm and revise World Health Organization/United Nations International Children's Emergency Fund Integrated Management of Childhood Illness guidelines to identify sick young infants for referral, 2) develop research studies with common research designs (1 site in each Bangladesh and Pakistan and a multicentre site in Democratic Republic of Congo, Kenya and Nigeria) and oversight mechanisms to evaluate antibiotic regimens (when referral is not accepted by the family) that are safe and efficacious, appropriate to the severity of infection, and deployable on a large scale and 3) utilize existing program delivery structures incorporating community health workers, skilled health workers to deliver simple antibiotic treatment when referral is not possible.
Conclusions:
This research program facilitated innovative research in different geographical, cultural and administrative milieus to generate recommendations for policy.
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