Who gets funded? Global analysis of research funding for newborn health and stillbirth in fragile and non-English speaking countries, 2016–2020

Despite global progress under the Sustainable Development Goals (SDGs); 2.3 million newborn deaths and 1.9 million stillbirths occur annually with disproportionate burdens in humanitarian and fragile settings. We investigated how newborn health research funding during the SDG era (2016-2020) varied by country fragility and language. We conducted a systematic analysis of research grants using the Dimensions database, categorizing grants by research theme, stage of research pipeline, funder type, and World Bank Income classification of funder and recipient countries. Grants were further analysed by Fragile States Index and official languages(s) of recipient countries. Between 2016-2020, $308.2 million USD was awarded for 1372 grants involving at least one low- or middle-income country (LMIC) recipient. Of this, 35% ($108.0 million) supported grants involving both an LMIC and a recipient from one of the 30 most fragile countries, while only 19% ($57.3 million) was awarded directly to organisations based in 30 most fragile countries. Among these fragile-state recipients, most funding supported interventional research ($33.6 million), with minimal investment in implementation ($5.0 million) or basic science ($2.8 million). Language disparities were evident: across all grants, recipients in English-speaking countries received the largest share ($115.5 million). Significant inequities persist in allocation of newborn health and stillbirth research funding. Despite bearing a disproportionate burden of neonatal mortality, organisations in non-English speaking countries and the 30 most fragile countries received limited research funding. These disparities contribute to gaps in evidence for impact in humanitarian settings, hinder implementation, and reinforce global research and health inequities. • Newborn health and stillbirth research funding analysis using Dimensions database. • Countries classified as most fragile, received minimal newborn research funding. • Funding favoured English-speaking countries over others with comparable mortality. • Limited funding for implementation research and basic science in fragile countries. • Inequitable funding creates evidence gaps and weakens health systems.