Early essential newborn care: a decade of scaling up quality, life-saving interventions across East Asia and the Pacific (2013–2023)
Howard Lawrence Sobel, John Charles Scott Murray, Priya Mannava, Vanya Delgermaa, Hien Van Pham, Zhao Li, Hoang Tran, Y Meng Chhour, Sethikar Im, Tung Rathavy, Rattana Kim, Sidonn Krang, Kannitha CHEANG, Sano Phal, Tao Xu, Sommana Rattana, Vimonlath Singharaj, Bouasengnignom Phrasithdeth, Outhevanh Kounnavongsa, Tsevelmaa Baldan, Barnabas Roland, Edward Waramin, Madeline Salva, Jessica Yaipupu, Anthony Pascual Calibo, Ruby Constantino, Marwynn Bello, Jacqueline Kitong, Annie Jatobatu, Tuan Anh Dinh, Khoa Dang Tran, Hoang Anh Tuan, Thi Quynh Nga Pham, Thyna Orelly, Tsogzolmaa Bayandorj, Eunyoung Ko, Maria Asuncion Silvestre, Elizabeth Mason, Hiromi Obara, Pamela Putney, Shogo KubotaIn 2013, WHO partnered with Ministries of Health and development partners in nine countries in Asia and the Pacific to develop, test and scale-up of Early Essential Newborn Care (EENC), a package of simple evidence-based interventions shown to prevent or treat the most important causes of newborn morbidity and mortality, delivered around birth or in the early newborn period. This effort became the largest regional collaboration to improve the quality of newborn care globally. This article discusses the key achievements and progress in the introduction and scale-up of EENC over the past decade, as well as the remaining challenges and future directions. Policy and programme documents, cross-sectional facility assessments and study data show that EENC was widely adopted across nine countries between 2013 and 2023 using a coaching and data-based approach, with sustained and vastly improved quality of care for all newborns including those born preterm, low birth weight and by caesarean section. Implementation replaced ineffective training-based approaches with on-the-job clinical coaching tailored to routine environments. Multidisciplinary hospital teams drove national scale-up and systems improvements by identifying what their facilities and those in their catchment population needed to support practice change. The periodic collection and immediate use of practice data for tracking progress and making programme decisions represented a significant change in how public health programme implementation and scale-up was conducted in the region.