The case of the neonate vs LMIC medical academia - a jury style systematic review of 32 years of literature without significant mortality reduction

Introduction – The high neonatal mortality rate in low- and middle-income countries (LMICs) such as Nigeria has lasted over thirty years to date with associated nursing fatigue. Despite the obvious hard work, technology improvements, and many publications being released from the country since 1990, the problem has persisted, perhaps, for lack of intervention scaleup. Could there be neglected discoveries unwittingly abandoned by Nigerian policymakers over the years, perhaps locked up in previous publications? A careful review may reveal these to alert policymakers, inspire researchers, and refocus in-country research efforts towards impactful direction for improved neonatal survival rate. The focus was to determine the prevailed effectiveness of LMIC medical academia in solution creation toward ending high neonatal mortality rate. Methods – An unconventional systematic review protocol structure along PRISMA 2020 checklist was designed and registered at INPLASY (registration number: INPLASY202380096, doi: 10.37766/inplasy2023.8.0096). A jury of paediatricians was assembled and observed by a team of legal professionals. The jury searched the literature from 1990 to end of 2022—extracted newborn-related articles about Nigeria, assessed, and debated these against expected solution-creation, translation, scale-up, sustainability and national coverage. Each juror used a preset criteria to produce a verdict on the possibility of a published novel idea being a potential game-changer for improving the survival rate of the Nigerian neonate. Results – Summation of the results showed that 19 out of 4,286 publications were assessed to possess the potential strategies or intervention to reduce neonatal mortality. Fourteen were fully developed but not appropriately scaled-up across the country, hence, denying neonates proper access to these interventions. Conclusion – Nigeria may already have the required game-changing ideas to strategically scale up across the nation to accelerate neonatal survival. Therefore, the LMIC healthcare systems may have to look inwards to strengthen what they already possess