The European Standards of Care for Newborn Health (ESCNH) are an interdisciplinary European collaboration to develop and update standards of care for key topics in newborn health. It brings together more than 220 healthcare professionals of different professions, parent representatives and selected industry specialists from over 30 countries. The ESCNH focus on the treatment and care of preterm and ill newborn babies from hospital to school age.
Our initial aim was the development of standards for 11 broad areas of neonatal health. The original development phase of the first 96 standards ran from 01/2013 to 12/2018. All standards developed in the project are available here. The first development and publication of the ESCNH was an important step towards harmonising treatment and care for preterm and ill newborn babies across Europe. Initiated by the European Foundation for the Care of Newborn Infants (EFCNI), the ESCNH serve as a reference for developing binding national guidelines, protocols, or laws (depending on the local situation).
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Worldwide, 15 million infants are born preterm annually. (1) In Europe, preterm birth is one of the leading causes for neonatal mortality and accounts for more than half of all infant deaths. (2). Although significant advances have been made in recent years and survival after preterm birth in Europe is continuously improving, preterm birth remains a major health issue for infants in Europe. A significant proportion of children, as well as their families, must cope with long-term physical, psychological, emotional, and financial challenges. The treatment for preterm and ill newborn babies is very complex and requires specially trained healthcare professionals. The organisation of care, the education of healthcare professionals, and the structure and provision of neonatal care varies widely across Europe. Currently, there are no pan-European guidelines covering the full spectrum of newborn health. The reasons for this are manifold. One reason is that within the European Union (EU), the national governments hold the primary responsibility to organise and provide healthcare services for their citizens (1). Thus, the organisation of healthcare systems differs both between individual EU member states as well as between EU- and non-EU countries.
Differences in healthcare systems include access to, funding of, and organisation of healthcare. The education and training of healthcare professionals as well as the delivery of treatment are also handled distinctly in different regions. Variation is not limited to national borders: Differences are also observed at regional and hospital level. These variations can further be seen in existing references, such as national guidelines, hospital policy, or the lack thereof. For many areas in newborn health, even national guidelines do not exist. Medical topics covered by national guidelines again vary between countries. On a national level, guidelines are commonly developed by either national committees, specialised guidelines-issuing bodies, or national professional associations. On an international level, efforts have been made by European professional societies or dedicated consortia to develop European guidelines, but similarly to national guidelines many areas are still neglected. The European Standards of Care for Newborn Health (ESCNH) address these disparities by developing reference standards for a wide range of topics in newborn health. The focus of the ESCNH is on the geographical definition of Europe.
The origin of the European Standards of Care for Newborn Health (ESCNH) goes back beyond the original conception of the project in 2013. As early as 2008, with the Declaration of Rome, demands for improving the treatment and care for preterm babies were formulated by EFCNI and partnering organisations. These demands were substantiated by the publications of the EU benchmarking report “Too little, Too late” in 2010 and the EFCNI White Paper on Maternal and Newborn Health and Aftercare Service “Caring for Tomorrow” in 2011/2012.
The project itself was symbolically kicked off in the European Parliament in 2014, where the Vice President of the Parliament, together with 80 parent and healthcare organisations, signed a large poster to show their support for the development of the European Standards of Care for Newborn Health.
In the following years, while the ESCNH were developed, the endeavour itself garnered more and more attention: starting with a workshop in the EU Parliament, it was also referenced in an editorial in the Lancet in 2016 and was eventually selected as a Landmark by Germany – Land of Ideas in 2017.
In order to pave the way for the implementation, two awareness campaigns, Socks for Life (running since 2013) and 11 months – 11 topics (running since 2016), accompany the ESCNH. In parallel, parent representatives are trained in how they can support the future implementation of the ESCNH all over Europe. Another step in the implementation process is the EFCNI Academy, which is an international education programme for healthcare professionals under the umbrella of EFCNI. With input from the most experienced professionals in the field, the EFCNI Academy offers high-quality training and educational materials on topics such as thermoregulation in preterm infants, resuscitation or topics within the first 1000 days of life. Click on the graphic below to learn more about the timeline of the ESCNH project.
The project to develop the European Standards of Care for Newborn Health (ESCNH) was initiated and is led by EFCNI. This is the first pan-European organisation and network to represent the interests of preterm and newborn infants and their families. It brings together parents, healthcare experts from different disciplines, and scientists with the common goal of improving long-term health of preterm and newborn children by ensuring the best possible prevention, treatment, care, and support. As initiator, EFCNI developed the idea for the project and won industry partners as well as professional healthcare and parent organisations to support the project. In its role as coordinator, EFCNI aligns the work of the Topic Expert Groups and the Chair Committee in addition to organising or facilitating meetings. Further, EFCNI is responsible for the administration and communication and has a leading role in regular revisions and the dissemination of the ESCNH.
