**5. Adaption requires scientific thinking**

Most of Nigeria's neonatal systems, techniques, and procedures are imported from the United Kingdom, Europe, or America where these are well-proven to be very effective, reliable, and sustainable. Unfortunately, similar outcomes would depend on the abilities of the importing country to adapt the application within their own variables of culture, climate, and infrastructure. This requires some scientific thinking. There may be a need to understand the basic physics of the application in order to know the aspect of the application that needs tweaking; and how best to do this to make the application reliably operable in the setting. The Nigerian scientific and research community must be alive, active, and confident to create such intermediate technologies. We think that a quicker success could be made if technologies are tweaked to fit the Nigerian weather and culture rather than the more difficult route of "tweaking culture for a piece of imported technology". This challenge is both for the Nigerian government but much more for the Universities, research institutions, and their Professors.

availability of over 15 functional incubators at all times. This grants them an outstanding position when compared with the other government centers that hide behind lack of funds to deny the neonates of this vital system. Any Nigerian hospital with any available casing of broken-down incubator does not actually have excuses to give in support of their denial and neglect for this basic neonatal need. The RIT upgrading or conversion is affordable and does not necessarily require special government subvention as many of our collaborating centers fund this from their internally generated revenue. This simple unconventional technology of the RIT is saving huge amount of lives in Nigeria without huge spending; hence, the Nigerian

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government and the custodians of neonatal health in Nigerian should pay attention.

measured by their willingness to prosecute defaulting professionals and institutions.

The widespread exposure of the neonate to hypothermia even when functional incubators are available can be due to epileptic power supply or outright power failures that last hours unending. The incubator becomes useless when there is no power to run it. Grid power failure can even last for days in Nigeria such that a standby fossil fuel generator becomes inadequate and unsustainable to provide uninterrupted incubator care. Nigeria is yet to provide a decisive solution for her inability to deliver uninterrupted grid power to the nation. Many centers rely on this limitation to offer excuses for the high neonatal mortality. In our few centers, however, the incubators run uninterrupted by the application of our power banking system (PBS) initiative. We used batteries to store up power from the grid and generators whenever these were available. This was in addition to trickling recharging of the batteries using photovoltaic cells mounted on the rooftops, especially when there was failure of both grid and fossil

The Nigerian climate can get excessively hot with a higher temperature of up to 47°C in some cities during the dry season [21, 22]. Preterm neonates are often unable to regulate their body

One wonders why routine maintenance of these items of neonatal equipment in Nigeria is so neglected. Neonatal systems such as the incubator, as a life support machine, works nonstop, day-in and day-out, yet the conventional Nigerian practice does not involve a compulsory regular maintenance by qualified personnel. Regular professional maintenance of neonatal systems, even in their countries of manufacture, is a routine never to be compromised. Yet anyone wonders why there are so many broken-down systems at Nigerian centers where machines are run continuously without servicing until they are destroyed. The systems at our centers are always functionally available because the hospitals run a six monthly mandatory failure-preventive audit culture (FAC) for the incubators. Similar assiduous care must be made compulsory at all SCBUs operating in Nigeria. Suffice to mention that many of the incubators are homes for the microbes that infect the dying neonates as a result of lack of routine technical cleaning and decontamination. As this is an unlawful life-threatening exposure of a neonate to harmful environment, the seriousness of the Nigerian government should be

**6.2. The failure-preventive audit culture (FAC)**

**6.3. The power banking system (PBS)**

generator powers that lasted longer than necessary.

**6.4. Evening-fever syndrome (EFS) antidote**
