Hospital Padrino Strategy associated with reductions in perinatal mortality in Colombia’s Pacific region: addressing public health challenges

BACKGROUND: The reduction of the perinatal and late neonatal mortality ratio (PNR) is a universal indicator of development. We describe the implementation of the Hospital Padrino Strategy (HPS), a collaborative model between a high-complexity hospital and 55 medium- and low-complexity hospitals from 2023 to 2025. The strategy included strengthening human health talent, utilizing Bubble continuous positive airway pressure (bCPAP), and implementing telehealth systems between hospitals. METHODS: A mixed-methods study was conducted in two phases across hospitals participating in HPS. Phase 1 involved the prospective evaluation of hospital performance and clinical indicators for perinatal and neonatal care over two years. Phase 2 collected qualitative data from healthcare personnel through focus groups to assess perceptions, barriers, and changes in professional practice. RESULTS: From January 2023 to June 2025, 60 workshops on neonatal care were held involving 1334 healthcare workers. Improvements were observed in hospital conditions and healthcare personnel's technical competencies. Seventy-nine neonates with emergencies received care through telehealth systems. During the implementation period, the PNR decreased from 13.37 to 6.91 per 1000 live births. Qualitative findings for 119 participants demonstrated strengthened professional commitment and collaborative culture. CONCLUSION: The HPS was associated with improvements in neonatal care conditions and reduced PNR in participating territories. IMPACT: The Hospital Padrino Strategy (HPS) was associated to reduce the Perinatal and Late Neonatal Mortality Ratio (PNR) from 13.37 to 6.91 per 1000 live births across 55 hospitals in Colombia's Pacific region (2023-2025). This study demonstrates the effectiveness of combining capacity-building, bubble CPAP implementation, and telehealth networks to improve neonatal care in low-resource hospital networks. Findings provide qualitative evidence of strengthened professional commitment and collaborative culture, highlighting human-resource engagement as a key driver for neonatal survival. This network-based strategy offers a model for Low-and Middle-Income Countries (LMICs), supporting global initiatives to reduce preventable neonatal deaths and improve health equity.