In recent years the introduction of Helping Babies Breathe in low-income countries has proven to be effective in reducing fresh stillbirth rates. Babies who would otherwise be considered to be fresh stillbirths are given a chance, helped to breathe and often survive without any complications. Vossius C, et al. Cost-Effectiveness of the “Helping Babies Breathe” Program in a Missionary Hospital in Rural Tanzania. PLoS ONE. 2014;9(7):e102080. This study for example showed a cost per life saved of just over 200 dollars, over the first year of the program. As the retraining is done without new equipment and during the hours of work, it costs next to nothing, so the costs per life saved should drop even further as the years go by.
Some babies do go on to need respiratory support, which is itself costly and in limited supply in middle resource countries.
A new paper from Nicaragua describes the results of introducing and promoting the use of bubble nasal CPAP in an NICU that was already providing assisted ventilation. (Rezzonico R, et al. Impact of the systematic introduction of low-cost bubble nasal CPAP in a NICU of a developing country: a prospective pre- and post-intervention study. BMC Pediatrics. 2015;15(1).) They showed that after the change in practice there were many more babies who only required CPAP, the proportion more than doubled to over 60%, and the mortality rate decreased despite an increase in admissions.