Review of Low-Cost Interventions for Reducing Neonatal Mortality and Morbidity in Low- and Middle-Income Countries

This review examines low-cost interventions for reducing neonatal mortality and morbidity in low- and middle-income countries (LMICs).

A systematic PubMed search and neonatal care data from World Health Organization (2014-2024) were used to revise interventions including prenatal care, early essential newborn care (EENC), resuscitation and therapeutic hypothermia, Kangaroo mother care (KMC), respiratory support, breastfeeding, sepsis prevention, safe neonatal transfer, neonatal network in LMICs and suggestions for improvement. Out of 9295 initially identified articles, 252 studies were selected as relevant to the research objectives.

In LMICs, the use of antenatal corticosteroids and magnesium sulfate remains limited in routine obstetric practice. Although EENC, KMC and early breastfeeding significantly reduce neonatal mortality, these interventions are under-prioritised and insufficiently implemented. Neonatal resuscitation and respiratory support are constrained by inadequate equipment and a shortage of trained healthcare personnel. Healthcare-associated sepsis, compounded by antibiotic resistance, continues to strain neonatal intensive care units. Additionally, unsafe neonatal transfers and poor coordination among different levels of neonatal care highlight the need for better integration within regional health systems.

To reduce neonatal mortality and enhance care in LMICs, systematic training, effective implementation and the sustainable delivery of proven, low-cost, high-impact interventions are urgently needed.