Wealth, place of birth, coverage of care at birth, and, in some cultures, also the newborn’s gender greatly impact the risk of dying and the health outcome of a newborn. The most vulnerable newborns are those in marginalised groups, rural areas, urban slum environments, conflict areas, and humanitarian settings. Too many newborns have only limited or no access to cost-effective, life-saving interventions, and the equity gap is continuously growing. Every day in fragile and humanitarian settings, an estimated 500 women and girls die from complications due to pregnancy and childbirth.
Some concrete examples of what can be done to help newborns survive under these most difficult circumstances:

• Keep babies and parents together: they are the most reliable source of warmth, feeding, and protection in crises.
• Strengthen and scale up essential care for mothers and newborns, focusing on cost-efficient and high-impact interventions, including empowering mothers with information on their individual risk level during pregnancy, thermal care, infection prevention, neonatal resuscitation, early initiation and support for breastfeeding, postnatal checks, delayed cord clamping, vitamin K administration, and eye prophylaxis at birth.
• Educate communities and health workers to identify danger signs before, during, and after pregnancy and monitor these. Develop systems of reliable transportation and communication to facilitate appropriate referral of mothers and newborns when danger signs are detected.
• Share broadly information of essential medicines and commodities (e.g. the field guide “Newborn Health in Humanitarian Settings”) to support safe birth and newborn survival during emergencies. Integrate these medicines into national essential medicines lists and implementing organisations’ supply lists.
• Recognise and guarantee the rights of newborns including birth registration and legal status. Count every newborn in all settings, including humanitarian settings, using birth (and death) registration.
• Integrate family planning during antenatal and postnatal care, encourage early and exclusive breastfeeding, and improve spacing between pregnancies.
With gratitude to: Roadmap to Accelerate Progress for Every Newborn in Humanitarian Settings 2020-2025, ENAP, 2019 and Global estimates for WASH in healthcare facilities, JMP, 2019/2020.

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