**4. Wholesale importation is unsustainable**

(MDG) would have empowered a great success. Since this was an unfortunate failure for the neonatal sector at the national level, Nigeria could restore hopes by a humble study of what constituted the pockets of successes recorded by some few centers that adopted unconven-

Neonatal health care professionals in West Africa, especially Nigeria, need to understand that the world expects them to apply whatever science they can manage to deliver a drastic reduction in the neonatal mortality rates as it has been known for the last 10 years. It ought to be a challenge to the health care providers in this country that no significant improvements have been achieved, even after ten years of accelerated campaigning and spending—from the 2007 demographic data of the World Health Organization (WHO) to that of Nigeria's Federal Ministry of Health (FMoH) of 2010, to that of UNICEF's 2012, and perhaps up to the indices of 2017 (**Figure 1**) [1, 11–14].

The question that remained unanswered is whether there are any more untried ideas left for the Nigeria's FMoH and the other custodians of neonatal health in Nigeria that can help

(a) Neonatal deaths accounting for nearly 50% of all deaths of children under 5 years of age

(b) Nearly 80% of all deceased neonates dying within their first 1 week of life [14, 16]

tional techniques.

224 Selected Topics in Neonatal Care

[1, 15]

**3. Change is compulsorily needed**

lower their well-known horrible indices, including:

**Figure 1.** Daily newborn mortality over last 8 years of MDG.

It is always attractive to import latest technologies for application in Nigeria. However, poor infrastructural development makes such applications unsustainable. Modern medical equipment is quite expensive and unaffordable to many medical institutions that must look after the neonates. However, the procurement of these systems is not necessarily the main problem. Sadly, the age long pattern at these mostly government-owned referral centers is such that after many years of impoverished neonatal outcomes and political harassments, the government manages to provide appropriate funds to purchase only few of the required equipment. However, no sooner this is done, the center goes back into comatose due to inability to maintain the systems. The efficiency of a system or procedure can often depend on factors relating to infrastructural base, climate, peoples' culture, work attitude, manpower, maintenance supply chain, etc. It is essential that these factors are carefully considered, or else a wholesale adoption of a foreign idea may not yield same result as expected. Nigeria's 100% reliance on importation of needed technologies and ideas are unsustainable due to these factors. The best options forward are either adaptation or synthesis of own solutions.
