"Quality improvement initiatives in neonatal intensive care unit (NICU) for improved care outcomes- a review of evidence"

Neonatal morbidity and mortality are recognized as a global public health challenge in developing countries, with the highest rate of mortality found in the poorest countries.1 The first four weeks of an infant’s life is their most vulnerable period, during which they are prone to significant morbidity and mortality. The NICU did not exist until the early 1960s, and the specialty of neonatology did not begin until the 1970s. These special units were established soon after the death of President John F. Kennedy’s newborn son, who died of respiratory distress and immature lungs. He was born prematurely after just thirty-four weeks of gestation. His death brought increased awareness in the United States to the numbers of preterm infants who were dying because of immature lung development shortly after their births. Knowledge and expert care of these infants increased, and by the early 1990s, more than 90 percent of these premature infants were surviving, including those infants born as early after just twenty-four weeks of gestation. Exposure of neonates to infections, birth asphyxia, and birth before term are considered as the most common causes of neonatal deaths. However, these common causes of the neonatal mortality in the neonatal intensive care units are mostly preventable.2