Of the 2.9 million newborn deaths that occurred in 2012, close to half of them occurred within the first 24 hours after birth. Many of these deaths occurred in babies born too early and too small, babies with infections, or babies asphyxiated around the time of delivery. Labour, birth and the immediate postnatal period are the most critical for newborn and maternal survival. Unfortunately, the majority of mothers and newborns in low- and middle-income countries do not receive optimal care during these periods.
Basic care for all newborns should include promoting and supporting early and exclusive breastfeeding, keeping the baby warm, increasing hand washing and providing hygienic umbilical cord and skin care, identifying conditions requiring additional care and counselling on when to take a newborn to a health facility. Newborns and their mothers should be examined for danger signs at home visits. At the same time, families should be counselled on identification of these danger signs and the need for prompt care seeking if one or more of them are present. Newborns with who have preterm birth or low birth weight, who are sick or are born to HIV-infected mothers need special care.
Newborns born in health facilities should not be sent home in the crucial first 24 hours of life, and postnatal visits should be scheduled. For all home births a visit to a health facility for postnatal care as soon as possible after birth is recommended. In high mortality settings and where access to facility based care is limited, WHO and UNICEF recommend at least two home visits for all home births: the first visit should occur within 24 hours from birth and the second visit on day 3. If possible, a third visit should be made before the end of the first week of life (WHO-UNICEF Joint Statement on Home Visits for Newborn Care). Key WHO documents that aim to improve skills of health workers in postnatal care include Essential newborn care course and the Integrated Management of Childhood Illness (IMCI) training materials.
Key WHO documents that aim to improve skills of birth attendants in newborn care at birth include Pregnancy, childbirth, postpartum and newborn care: a guide for essential practice and Essential newborn care course.