Dr Uduak Okomo was awarded Pump Priming grant of £10,000 to carry out a facility-based evaluation of stillbirths and neonatal deaths in The Gambia, as part of her post-doctoral research activities. The funding for this award is provided by the Institutional Strategic Support Fund (ISSF), supported by Wellcome and the LSHTM. Stillbirths and death of a newborns are tragic events for any family and continue to occur in large numbers in low- and middle-income countries (LMIC). Out of hundred babies born in The Gambia, three are likely to die within the first month of life, compared to four out of every thousand in the United Kingdom.

In The Gambia, stillbirth figures, particularly those occurring after the onset of labour but before birth, are not always accurately recorded. In addition to maternal infections, many other factors play a role in the origin of both stillbirths and neonatal deaths. Some stillbirth and neonatal deaths can be completely preventable with already proven measures such as having a skilled attendant at birth, neonatal resuscitation at birth to support the establishment of breathing, kangaroo mother care, and management of severe infections in newborns. However, in The Gambia, there is limited information about numbers and causes, there is no systematic recording system to facilitate the analysis of root causes, and hence intervention strategies are poorly informed.

Consistent information about the nature and cause of death is needed for planning health systems and distributing resources, as well as for improving the quality of care at the point of service delivery.

The project will gather in-depth information about neonatal deaths and stillbirths at the major birth facilities in the western health region of The Gambia, facilitated by The Unit’s close interactions with governmental partners and UNICEF. It will also collect data on the level of surface bacterial contamination in the delivery areas. This will lay the foundation to evaluate pathogens, routes of transmission and potential evolution of antimicrobial resistance among neonates, particularly within facility-based deliveries. This research will build on Dr Okomo’s previous studies investigating the aetiology of serious infections among neonates admitted to the three main referral health facilities in The Gambia, and the role of mother-to-newborn transmission of potentially pathogenic bacteria from the maternal genital tract in the neonatal sepsis.The results of these studies suggest that most of neonatal infections in this setting may be acquired from the environment. This study will be led by Dr Uduak Okomo and Professor Beate Kampmann, MRC Unit The Gambia at LSHTM. Other key collaborators include Professor Joy Lawn, (MARCH Centre LSHTM), Dr Melisa Martinez-Alvarez (MRCG at LSHTM), Mrs Mariama Janneh, (UNICEF The Gambia), Dr Mamady Cham (Directorate of Health Services), and Mr Ba Foday Jawara (Reproductive Maternal Newborn Child and Adolescent Health Unit, Ministry of Health and Social Welfare The Gambia). Dr Uduak Okomo awarded a Pump Priming Grant from the Wellcome Institutional Strategic Support Fund (ISSF)