Complications related to preterm birth are the leading cause of neonatal death worldwide. A significant majority, over 80%, of these preterm births occur in sub-Saharan African and Asian countries. Antenatal corticosteroids (ACS) are known to decrease mortality and complications among preterm births. While more than 90% of eligible mothers in high-income countries utilize ACS, its usage in low- and middle-income countries is considerably lower, at around 40%.

The implementation research is a multi-country study that will be carried out in four countries with a high incidence of preterm birth and neonatal mortality. These countries include two in Africa (Ethiopia and Nigeria) and two in South Asia (Bangladesh and Pakistan). The research has two phases. The first phase aims to develop and evaluate an optimized implementation model in low- and middle-income countries (LMICs) that can achieve a high population-level coverage of safe ACS use (70%). The second phase aims to scale up the optimized implementation model and evaluate its impact on the coverage of safe ACS use and neonatal mortality.