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Centre for Global Child Health

An Integrated Toolkit to Save Newborn Lives in Pakistan

Principal Investigators: Dr. Shaun Morris, Clinician Scientist in the Division of Infectious Diseases and Scientist-Track Investigator, Centre for Global Child Health and Child Health Evaluative Services, Research Institute, The Hospital for Sick Children (SickKids), and Dr. Zulfiqar Bhutta, Centre of Excellence in Women & Child Health, Aga Khan University, Centre for Global Child Health, The Hospital for Sick Children, Toronto.


Worldwide, an estimated 2.9 million neonatal deaths occurred in 2012, accounting for nearly half of all under-five deaths. In Pakistan, more than 200,000 newborns die annually and neonatal mortality rates are higher than in any other South Asian country. Dr. Morris and his team have developed and are trialing an integrated newborn survival kit that is low-tech, cost-effective, easy-to-use and contains high impact interventions that can fit in a Ziploc bag—all for less than $5 per kit.  The kit is designed to reduce or provide early identification of the most common causes of newborn death, including infection and complications related to premature birth and low birth weight, in some of the world’s most at risk and hard to reach populations. As the development of the growing brain can be affected through the same insults that are major causes of mortality, reducing the number of these insults or detecting them sooner, may not only save lives but may also improve neurodevelopment.

Contents of the tool kit (which costs less than $5) include:

  • A clean delivery kit to minimize infection at time of delivery.
  • Chlorhexidine, which is applied to the umbilical stump and reduces certain severe infections by 75 per cent and mortality from all causes by 25 to 40 per cent.
  • An emollient to promote skin integrity, helping to reduce infection and prevent hypothermia (and shown to reduce mortality in hospitalized preterm infants).
  • A handheld scale to identify low birth weight.
  • ThermoSpot to continuously monitor temperature and identify hypothermia and fever.
  •  A mylar infant sleeve and reusable heating device to treat hypothermia.


“There are over three million neonatal deaths annually and approximately two-thirds are due to infection, low birth weight and prematurity. Our project, in collaboration with Aga Khan University, is a designed to bring health care directly to those newborns most at risk. We plan to enroll 14,000 newborns in two trials and hope to show that we can reduce newborn mortality by over a third for just a few dollars per infant,” says project leader Principal Investigator Dr. Shaun Morris.

Project collaborators include the Aga Khan University, Pakistan.

Supported by: Grand Challenges Canada, UBS Optimus Foundation and March of Dimes Foundation.

Project contact: shaun.morris@sickkids.ca