An exploratory evaluation of the acceptability of revised physician examinations in South Africa initiated during the coronavirus disease 2019 pandemic.

Neonatal meningitis is an inflammation of the meninges and cerebrospinal fluid within the first 28 days of life. It is mainly caused by bacteria, while viruses, fungi, and other infectious agents are also implicated. There were an estimated 190,515 deaths from meningitis globally in 2017, of which 93% were occurred among neonates. Children living in resource-limited settings are disproportionately affected by the disease, possibly due to lack of access to skilled birth attendance, inadequate postnatal care services, low vaccination coverage, malnutrition, persistent poverty. The World Health Organization’s (WHO’s) “defeating meningitis by 2030″ roadmap endorsed by Eastern Sub-Saharan Africa (ESSA), targets an epidemic-free future, aiming to reduce mortality by 70% and halve vaccine-preventable cases. However, despite regional progress with Hib, pneumococcal, and MenAfriVac vaccines, neonatal meningitis remains a critical blind spot in ESSA. The broad GBD metrics offer valuable macro-level trends, their global scale masks the devastating mortality and neurodevelopmental toll of neonatal meningitis, however existing analyses largely stop around 2021, which masks the specific epidemiology, etiologies, and distinct health burdens of neonatal meningitis. Moreover, the ESSA region faces distinct socioeconomic, geographic, and climate macro-determinants that diverge significantly from other regions. Surveys often overlook neonatal meningitis, and while a lack of comparable epidemiological data undermines prevention and control initiatives. This deficit of evidence highlights the urgent need for further research to improve the effectiveness of these health interventions. Remarkably, by utilizing the updated GBD 2023 dataset, to the best of our knowledge this study, 33-year long-term evaluation that extends through 2023. This timeline captures the critical post-pandemic recovery window, showing how recent global health disruptions affected regional neonatal survival. By isolating the exact metrics of incidence and Years of Life Lost (YLLs) due to premature mortality due to neonatal meningitis in ESSA region from 1990 to 2023, this study helps address an important evidence gap. It delivers the precise data required by regional public health sectors to optimize neonatal intensive care resources and design targeted maternal-neonatal preventative care initiatives.