The BORN Project
The Newborn Foundation has been actively working with global health agencies, clinicians, NGOs and the medtech industry on the implementation of the BORN Project – Birth Oximetry Routine for Newborns. The inaugural pilot project is being conducted in collaboration with provincial and county-level hub hospitals, the Chinese Ministry of Health and the National Office for Maternal and Child Health Surveillance, and will evaluate nearly 50,000 newborns at county and village birth facilities in Sichuan Province.
The BORN Project’s education-and-implementation model will provide clinical education, data, and screening framework leveraging the first low-cost, clinical-grade, commercialized mobile phone pulse oximeter designed for accurate measurements of hypoxemia (low oxygen saturations) in newborns.The project will provide the first actionable data on the effectiveness of pulse oximetry screening with mobile devices for newborns - and will drive larger adoption of pulse oximetry screening as a public health imperative in reducing newborn mortality around the world.
Combatting Newborn Mortality
Globally, nearly 41% of all under-five child deaths are among newborn infants, babies in their first 28 days of life. And three-quarters of all newborn deaths occur in the first week of life. Newly published data from the U.K. shows that of those babies who were asymptomatic, but failed newborn pulse oximetry screening, 79% had a significant problem. Of those problems, 10% were cardiac, 33% had unrecognized pneumonia, 18% had sepsis, and 7% had pulmonary hypertension – reinforcing the critically important role of pulse oximetry in identifying often-treatable health conditions in newborns. China has among the highest number of newborn deaths as a percentage of under 5 deaths. There is now evidence that using pulse oximetry and having reliable oxygen sources in district and provincial hospitals in developing countries can specifically reduce infection-related newborn death rates by as much as 35%.
The Newborn Foundation’s pilot was part of a first of its kind newborn screening infrastructure and field research study, which began in late 2012 and took place in country in April 2013. The inaugural China Summit on Newborn Screening and Early Detection of CHD was held in Beijing and included clinicians, and international delegation of newborn health experts, and senior public health officials at the national level and from 31 Chinese provinces. Focused on the broader goal of detecting hypoxemia, the BORN Project leverages centers in urban and rural provinces, and a coordination and technical assistance center located at academic hospital centers in Chengdu, Shanghai and Beijing respectively to:
- Create comprehensive training materials and drive program implementation;
- Develop a functional screening protocol, currently being adapted to conform to the needs of front-line clinicians;
- Provide important data to support screening, treatment/referral capacity in low-resource and diverse locations.
National and provincial level public health officials will be able to use the data gathered in this stage to support the addition of pulse oximetry screening and a population health imperative.
Aligning with Global Health
As a global newborn screening initiative, the BORN Project is also well-aligned with the WHO’s Safe Childbirth Checklist (SCC). Initially unveiled at the International Conference on Birth Defects in the Developing World (ICBD), November 2013 in Cebu, Philippines, the BORN Project will utilize a tested neonatal screening algorithm as the pilot model for early detection of pneumonia and sepsis. Congenital Heart Defects remain the most common and deadly of all birth defects, and will be an important secondary detection target for this non-invasive measure of blood oxygen saturation in newborns.
The Newborn Foundation has recently joined with the Every Newborn Action Plan (ENAP) in its efforts to address MDG #4, reduce neonatal mortality and to trigger additional NGOs and international health bodies to support pulse oximetry evaluation as a standard practice for all newborns, regardless of geography. Thanks in part to the Newborn Foundation and Newborn Coalition advocacy, newborn pulse oximetry screening is being implemented in a growing number of countries around the world.