Ending Preventable Infant Mortality

“I am now an example in my community. I am so happy my babies survived.”

– Sifati, Program Participant, Malawi

Ending Preventable Infant Mortality

“I am now an example in my community. I am so happy my babies survived.”

– Sifati, Program Participant, Malawi


Newborns are among the world’s most vulnerable citizens. Every year, an estimated 2.5 million newborns die during the first 28 days of life—that amounts to 7,000 newborn deaths every day and accounts for nearly half of all child deaths under the age of 5 worldwide. Typically, these children suffer from conditions and diseases associated with a lack of skilled, quality care and treatment at birth or in the first few days of life. Preterm birth, lack of breathing at birth, infections, and birth defects are the leading causes of newborn mortality.

We know newborn survival depends largely on where a baby is born. Low income countries account for the highest rates of mortality and disability. Yet, most newborns can survive and thrive if they have access to quality health care, during and immediately following birth. We also know positive newborn outcomes are directly linked to the quality of care women receive before, during, and after pregnancy.

Reducing Infant Mortality Rates Worldwide

PCI strives to create enabling environments that support maternal and newborn health and reduce infant deaths. We believe the continuum of care is a shared responsibility among families, communities, civil society organizations, governments, religious groups, professional associations, and the private sector.

In turn, PCI provides integrated, community-driven programs that ensure that mothers and newborns receive the health care and services they need, when they need it.

Improving Newborn Care in India

PCI is working to reduce infant mortality in India through the JEEViKA Technical Support Program. In Bihar, PCI helps integrate maternal and newborn health messaging into women’s Self-Help Groups. These groups provide a valuable avenue to build community awareness around infant mortality causes and empower women to change harmful health norms and behaviors.

So far, PCI has formed 19,000 health-focused Self-Help Groups with women of reproductive age from the most vulnerable communities. In the meetings, pregnant women and young mothers receive information about life-saving maternal and newborn health practices and behaviors that support newborn care and survival.

An evaluation found that women from these groups were more likely to deliver babies in a care facility, practice skin-to-skin contact with their newborn, initiate timely breastfeeding and exclusively breastfeed their infants, as well as provide age-appropriate immunizations after just eight group sessions.

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Reducing Infant Mortality Along the U.S.-Mexico Border

PCI is pioneering the use of human-centered design to reduce infant mortality, primarily among Latina women, in four U.S.-Mexico border states—California, Arizona, New Mexico, and Texas. The program, called the Collaborative Improvement & Innovation Network (CoIIN), seeks to increase prenatal care attendance through uniquely designed interventions.

Human-centered design and design thinking are innovative approaches to problem solving that involves building deep empathy with your audience, extensive brainstorming, and iterative testing of intervention prototypes.

Since 2018, CoIIN participants engaged in the formation of ideas, designing and testing interventions, and measuring their feasibility and impact. Each state created its own individual intervention to improve prenatal care and reduce infant mortality.

A few notable successes include:

  • In Texas, prenatal care scheduling delays have decreased to an average of eight days (down from 16) and enrollments in Medicaid have nearly doubled among pregnant women clients at University Medical Care clinics.
  • In southern Arizona, youth have participated in the development, testing, branding, and launch of an interactive chatbot that answers questions and connects teens to free and confidential resources and services to increase their use of prenatal care and other important sexual and reproductive health services.
  • The University of New Mexico is using human-centered design approaches to engage community health workers in the development and roll out of a new preconception and prenatal care curriculum for the statewide certification program.
  • In California, where significant numbers of individuals access care on both sides of the border with Mexico, CoIIN efforts led to updated national guidance, including prenatal care received outside the U.S., and using languages other than English in birth certificate information, contributing to improved quality of vital statistics.
  • PCI is working on this project in partnership with Abt Associates with funding from the U.S. Department of Health and Human Services

PCI In Action

Catalyzing Global and Country Action for Vulnerable Newborns

For five years, PCI led Every Preemie-SCALE, a project designed to catalyze action, globally and at the country level, toward improving newborn health, particularly among babies born too soon.

Every Preemie engaged with global partners, including the World Health Organization (WHO), UNICEF, and USAID, as well as leading newborn health experts to elevate preterm birth, low birth weight care, and sick newborn care around the world. In USAID priority countries, PCI engaged in thought leadership discussions on these topics as well as designed and disseminated tools and products featuring early/small and sick newborn care and management.

Other program activities included:

  • Launching country profiles on preterm birth and low birth weight to promote dialogue and action in USAID’s 25 priority maternal and child health countries
  • Providing technical input on WHO standards of care for early/small and sick newborns
  • Developing and disseminating the global WHO/UNICEF document Survive & Thrive: Transforming Care for Every Small and Sick Newborn
  • Revising the global Respectful Maternity Care Charter to include newborns
  • Designing a protocol and tools for situation analysis on the care of inpatient newborns and young infants, which were used in Ghana, Rwanda, Tanzania, and Uganda

This project also supported research in Bangladesh, Ethiopia, India, and Malawi in partnership with Brigham and Women’s Hospital, St. Paul’s Hospital Millennium Medical College, the Post-Graduate Institute of Medical Education and Research, and the University of Malawi College of Medicine and MaiKhanda, respectively.

In Malawi, this research laid the foundation for the innovative Family-Led Care model. This model was designed to improve health services while empowering families to care for their early/small babies in a facility and at home. The Family-Led Care model helps improve the quality of Kangaroo Mother Care provided to inpatient preterm and low birth weight newborns; strengthen post-discharge follow-up care; and extend care for preterm and low birth weight newborns at community and household levels.

Saving Mothers Giving Live: A Partnership in Zambia

In partnership with the Ministry of Community Development/Mother and Child Health, PCI trained health care providers in Kangaroo Mother Care for stable preterm birth and low birth weight babies who needed thermal protection, adequate feeding with mother’s milk, frequent observation, and protection from infection.

The training focused on Kangaroo Mother Care services which began at the health facility and continued at home under supervision. To address high neonatal mortality, PCI leveraged existing child survival program facilities, including maternal, newborn and child health and the prevention of mother-to-child transmission of HIV platforms, to increase attention to effective postnatal care.

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