Strengthening Neonatology in Ethiopia: From Survey Data to System Improvement

Neonatology. 2026 Feb 9:1-18. doi: 10.1159/000550774. Online ahead of print.

Abstract

Introduction: Neonatal care in low-resource settings is hindered by shortages of trained staff, inadequate infrastructure, and limited equipment and medications that compromise the management of common neonatal conditions and reduce the quality of care. Our aim was to describe the collaborative efforts between the Italian Agency for Development Cooperation (AICS), the Union of European Neonatal and Perinatal Societies (UENPS), Doctors with Africa CUAMM, the Ethiopian Paediatric Society (EPS), and the Ethiopian Federal Ministry of Health (FMoH) to assess resuscitation and respiratory care practices in Ethiopian NICUs, identify gaps, and guide targeted interventions.

Methods: A 50-item survey was distributed to 48 Ethiopian NICUs. Based on the survey results, a national workshop in Addis Ababa and a neonatal resuscitation 'Train the Trainers' course were scheduled. In parallel, funds were allocated to initiate renovations and equipment upgrade at two selected sites.

Results: The survey showed that most units lacked essential resuscitation equipment. Non-invasive respiratory support mainly relied on homemade CPAP systems; mechanical ventilators were available in <40% of units. Caffeine was rarely used, and surfactant was unavailable. The national workshop led to a document shared with the FMoH outlining priorities for subsequent training and resource strengthening. Newly trained instructors conducted four local neonatal resuscitation courses, training 150 healthcare providers. Facility upgrades addressed water, power, medical gas systems, and refurbishment of deteriorated areas.

Conclusions: The survey revealed major gaps in neonatal care in Ethiopia. Collaborative efforts by AICS, UENPS, CUAMM, EPS, and FMoH helped reinforce key infrastructures, and promote delivery room and respiratory care.