Every newborn deserves high-quality care. Expanding access to newborn care is essential, but access alone is not enough. Care must also be safe, timely, effective, evidence-based, equitable, respectful, and responsive to the needs of newborns and their families.

For the Global Newborn Society, quality improvement is the continuous effort to make newborn care better. It means measuring what matters, identifying preventable harm, learning from both success and failure, and translating that learning into safer and more reliable systems of care.

Every newborn should receive the right care, at the right time, in the right way, wherever that newborn is born.

 

FROM ACCESS TO OUTCOMES

Around the world, access to childbirth and newborn services has expanded, but availability does not necessarily guarantee quality. A health facility may exist without essential equipment; equipment may be available without appropriately trained personnel; and evidence-based practices may be known but inconsistently implemented. Newborns may reach health facilities yet experience delays in recognition, treatment, referral, or transport.

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Quality improvement seeks to close these gaps through an interconnected:

ACCESS → QUALITY → OUTCOMES axis

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Access asks: Can the newborn receive care?

Quality asks: Is the right care delivered safely, effectively, and reliably?

Outcomes ask: Did that care enable the newborn to survive and thrive?

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Improving newborn health globally requires progress across all three.

 

MEASURE WHAT MATTERS

Newborn mortality remains a critical global indicator, but survival alone cannot define high-quality care. We must also consider survival without preventable morbidity, neurodevelopment, infection, hypothermia, nutrition, breastfeeding and human milk provision, respiratory complications, medication safety, readmissions, family experience, respectful care, and continuity after discharge.

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Measurement should ultimately answer a simple question:

Are newborns receiving better care and achieving better outcomes because of what we are doing?

Data should enable learning, reveal disparities, identify opportunities for improvement, and determine whether interventions actually produce better outcomes.

 

PREVENT HARM

Many threats to newborn health are preventable. Failures in thermal protection, infection prevention, resuscitation, respiratory and oxygen management, nutrition, medication administration, recognition of deterioration, communication, referral, and transport can transform treatable conditions into serious illness or death.

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Adverse outcomes and near misses should therefore become opportunities for systematic learning. The central question is not simply who made an error, but why the system allowed harm to occur and how it can be redesigned to prevent recurrence.

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Safer care depends upon reliable processes, communication, teamwork, appropriate staffing, standardized practices where appropriate, education, simulation, measurement, and feedback.

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GLOBAL STANDARDS, LOCAL SOLUTIONS

Quality should be universal, but the pathways used to achieve it cannot always be identical.

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Newborn care is delivered in environments ranging from highly technological neonatal intensive care units to rural facilities with limited personnel, transportation, electricity, oxygen, laboratory services, or equipment. Disease burdens, cultures, geography, workforce capacity, and health systems also differ.

Quality improvement must therefore combine universal expectations with locally appropriate solutions.

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The goal is not to reproduce the same model of neonatal care everywhere. It is to establish essential standards, identify barriers to achieving them, and develop solutions that are effective, affordable, sustainable, and appropriate for each setting.

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Innovation also does not belong only to resource-rich health systems. Important advances have emerged from settings where limited resources demanded simplicity, adaptability, community engagement, task sharing, and efficient use of available resources. Global improvement requires bidirectional learning.

 

EQUITY IS QUALITY

A health system cannot claim high quality if excellent outcomes are available only to some newborns.

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National and institutional averages can conceal substantial differences among regions, communities, hospitals, and populations. Quality improvement must therefore ask not only whether outcomes are improving, but also who is benefiting and who is being left behind.

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Geography, poverty, conflict, displacement, inadequate infrastructure, and limited access to skilled personnel can profoundly affect newborn outcomes.

Where a newborn is born should not determine the quality of care that newborn receives.

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NEWBORNS AND FAMILIES AT THE CENTER

Quality newborn care is not defined solely by technical excellence. Newborns exist within families, and families should be respected as partners in care.

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Whenever possible, quality improvement should prevent unnecessary separation, protect the mother–infant dyad, facilitate parental presence and participation, support skin-to-skin care and human milk feeding, and ensure compassionate and understandable communication.

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Technology should strengthen human care rather than replace it.

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BUILD SYSTEMS THAT LEARN

Sustainable improvement cannot depend upon exceptional individuals working exceptionally hard. It requires systems capable of learning.

Health-care teams should be empowered to identify problems, test solutions, measure results, learn from adverse events and successes, and continuously refine care.

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Countries and institutions must also learn from one another. A solution developed in one hospital may inform another. An innovation created in a resource-limited environment may improve care in a resource-rich setting. Knowledge should move in every direction.

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The Global Newborn Society supports collaborative learning through which clinicians, nurses, researchers, families, institutions, and health systems can share experience, data, innovations, and successful approaches to newborn care.

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OUR COMMITMENT

The Global Newborn Society advocates for a global culture of continuous improvement: meaningful measurement, prevention of avoidable harm, evidence-based and reliable care, equity, locally appropriate innovation, respectful family-centered care, protection of the mother–infant dyad, multidisciplinary teamwork, education, and collaboration across institutions, countries, and regions.

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Quality improvement is not a project with an endpoint. It is a continuing responsibility to examine what we do, measure what happens, learn from what we find, and make the next newborn's care better than the last.

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Access gives a newborn the opportunity to receive care. Quality determines what that care can achieve.

Our goal is not simply more newborn care.

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Our goal is better care, better outcomes, and a better beginning for every newborn, everywhere.