Analysis of stillbirth risk factors, timings, and the acceleration needed in SBR reduction to meet the Every Newborn Action Plan (ENAP) 2030 target of £12 stillbirths per 1000 births in each country by 2030 were undertaken. Results Date available covered 500 million births from 160 countries. An estimated 2.6 million stillbirths occurred in 2015, with 1.3 million occurring during labour, and ten countries accounting for two-thirds of stillbirths (Figure 1). There has been an average annual rate of reduction (ARR) in stillbirth of 2% since 2000, compared to 3% for maternal mortality, and 4.5% for post-neonatal under-5 mortality. To reach the 2030 tar- gets, progress in SBR reduction will have to double (ARR of 4.3%), with even greater progress required in the highest burden settings (Figure 2). Stillbirths are strongly linked to poor maternal and fetal health, with potentially modifiable factors identified such as malaria (population attributable fraction (PAF) 8·2%), syphilis (7·7%), obesity (10%), smoking (1.7%), maternal age >35 years (6·7%) and prolonged pregnancy (14.0%). Stillbirths frequently ensue because of fetal growth restrictions and/or preterm labour. Congenital abnormalities only accounted for 7.4% of stillbirths. Conclusions Preventable stillbirths represent the extreme end of fetal pathology that leads to significant childhood morbidity and mortality. Our new estimates will contribute to efforts to meas- ure progress in SBR reduction worldwide, and inform evidence- based policy to improve child health. Paediatricians are increas- ingly advocating for stillbirth reduction, with wider benefits in improving neonatal and developmental outcomes from improv- ing prenatal fetal health increasingly clear. G267 IMPROVING NEONATAL THERMAL MONITORING AND CARE BY EMPOWERING PARENTS 1,2 JK Woodruff, 1,3 JE Gaiottino, 1 A Maburuka. 1 Neonatal Unit, Jinja Regional Referral Hospital, Jinja, Uganda; 2 Paediatric Department, Royal Berkshire Hospital, Reading, UK; 3 Neonatal Department, St Mary’s Hospital, London, UK 10.1136/archdischild-2016-310863.259 Aims Neonatal mortality has improved greatly in line with MDG4 but remains a major global challenge. Studies in Africa show prevalence of neonatal hypothermia of up to 85%, associ- ated with increased mortality. Parents are an important resource in Low Income Settings, and peer counsellors have proven efficacy in other studies. We hypothesised that empowering parents to monitor their newborn’s temperatures with the assis- tance of a designated Parent Temperature Champion would ena- ble better thermal control and improve outcomes. Methods A temperature chart was introduced to the Neonatal Unit at Jinja Regional Referral Hospital in November 2014 (Figure 1). Parents were taught to use thermometers, record tem- peratures, and treat hypothermia, overseen by a Parent Tempera- ture Champion. We retrospectively audited notes of babies with a birth weight <2kg admitted during 2 months before this inter- vention (n = 45), and 2 months after (n = 36). Results We found a significant increase in the average tempera- ture from 36.28 o C to 36.43 o C (p < 0.01) (Figure 2). Average numbers of temperatures recorded per day of admission also increased (1.2 temperatures taken per day to 1.9, p < 0.001). The percentage of temperatures which were severely hypother- mic (£34.9 o C) reduced significantly from 8.9% to 2.8% (p < 0.0001). Similarly, the percentage of temperatures which were moderately or severely hypothermic (£35.9 o C) decreased signifi- cantly from 27.9% to 19.9% (p < 0.01). However, the percent- age of temperatures showing any degree of hypothermia (£36.4 o C) remained the same (48% to 44%, p = 0.27) (Figure 3). The percentage of days of admission with severe hypother- mia (£34.9 o C) reduced from 8.1% to 4.6% (p < 0.07), however this trend did not reach statistical significance. The number of deaths, discharges and “runaways” did not change significantly. Conclusion The introduction of a caretaker-completed tempera- ture monitoring chart with a Parent Temperature Champion has resulted in a highly significant increase in the average tempera- ture and number of temperatures recorded, and a decrease in moderate and severe hypothermia in neonates below 2kg. G268 PRENATAL AND PERINATAL RISK FACTORS FOR CHILDHOOD DISABILITY IN A RURAL NEPALI BIRTH COHORT 1 E Haworth, 2 KM Tumbahangphe, 3,4 A Costello, 2 D Manandhar, 2 D Adhikari, 2 B Budhathoki, 2 DK Shrestha, 2 K Sagar, 3 M Heys. 1 Institute of Child Health, University College London, London, UK; 2 Mother and Infant Research Activities, Kathmandu, Nepal; 3 Institute for Global Health, University College London, London, UK; 4 Department of Maternal, Newborn, Child and Adolescent Health (MCA), World Health Organisation, Geneva, Switzerland 10.1136/archdischild-2016-310863.260 Abstract G267 Figure 1 Abstracts archdischild 2016;101(Suppl 1):A1–A374 A149