Submission ID 130833
| Issue/Objective | The neonatal period is the most vulnerable phase of life, with children in low- and middle-income countries (LMICs) facing an 11-fold higher mortality risk than those in high-income settings. Bacterial infections cause 25% of annual neonatal deaths globally, with healthcare-associated infections (HAIs) in LMICs occurring at rates 3-20 times higher than in affluent regions. In these precarious systems, multidrug-resistant organisms (MDROs) increasingly compromise first-line treatments. This abstract describes a strategic shift from static "gold standards" to a grounded, stepwise approach to neonatal safety through the implementation of an intersectional IPC assessment tool. |
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| Methodology/Approach | MSF implemented a 3-Pillar AMR Strategy (IPC, Antimicrobial Stewardship, and Diagnostics) across its global operations. Within this framework, the Stepwise IPC Assessment (SIPCA) Neonate tool was launched in April 2024 as an intersectional initiative across pediatric, nursing, and IPC platforms. The tool provides an accountability framework allowing field teams to measure progress across three levels of care (Ideal, Acceptable, and Minimal). The methodology focused on local-level implementation, remote peer support via communities of practice, and real-time data visualisation via Kobo dashboards. |
| Results | Between April 2024 and the end of 2025, SIPCA-Neonate achieved 86% coverage across relevant MSF projects, including emergency settings in Sudan, representing 117% growth in implementation. Global compliance improved from 58% to 67%. Notable improvements were recorded in "Baby Friendly Hospital" scores (+92%), injection safety (+49%), and skin-to-skin care (+42%). Overall SIPCA coverage for all inpatient departments reached 100% in 2025, with compliance rising from 43% (2020) to 57% (2025). |
| Discussion/Conclusion | Collectively reclaiming global health equity requires tools that translate high-level research into grounded action. The SIPCA-Neonate results demonstrate that a stepwise approach-prioritising incremental safety gains over unattainable "gold standards"-empowers frontline workers in precarious settings. By integrating IPC with antimicrobial stewardship and leveraging real-time remote support, health systems can maintain an ethical baseline of care during polycrises, ensuring that neonatal safety remains a human right, regardless of resource constraints. |
| Presenters and Affiliations | Aniroda Broomand Médecins Sans Frontières Aniroda Broomand Médecins Sans Frontières Lindsay Ross Médecins Sans Frontières Jasper Wagan Médecins Sans Frontières |
