Nigeria did not achieve the millennium development goal (MDG) for the reduction of under-5 mortality (U5M) in 2015. Neonatal death still accounts for nearly 50% of U5M, hence responsible for this failure. The World Health Organisation records showed that 79% of deceased neonates would die within the first-seven-days (F7D) of life in Nigeria. Prolonged postnatal delay before attainment of normal body temperature could be partly responsible. Reducing F7D deaths could improve Nigeria's overall record; hence the urgent need to device a technique that could be applied to achieve this. We developed a neonatal temperature control protocol "the initial-setpoint-algorithm (ISA)" as a response to temperature-related high F7D mortality rate. A total 134 cases (105 controls and 29 tests) were recruited. The cases drew from extremely-low birth weight and preterm neonates (BW = 600-1200 g, GA = 26-32 weeks) presenting at the University of Abuja Teaching Hospital Nigeria. Mortality outcomes were compared to investigate how the ISA group performed relative to the Control group. Applying ISA, Test-patients attained normotherm in 0.47 hr post-presenting (95%CI: 0.2); Control took 12.4 hrs (95%CI: 2.3). The F7D-deaths contribution to mortality in the control group was 71% (41 out of 58). There was no F7D death amongst the only two deceased neonates in the test group. The ISA helped quick attainment of normotherm in the Test-group; hence removed the immediate postnatal long exposure to damaging thermal shock that trailed other neonates to death within the F7D period.

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