As reflected in Millennium Development Goals 4 and 5 and now the Sustainable Development Goals, our objective is to reduce the global burden of preventable deaths.

In the case of newborn work, we focus particularly on stillbirths, maternal deaths, and newborn deaths. Meeting our objectives at the level of whole populations requires that we do much better in ensuring that the highest proportion possible adopt key practices and receive specific interventions. We need high effective coverage at scale for key behaviors and specific high-impact elements of care. While “scaling-up” may be part of how we achieve sustained impact at scale, we must guard against scale-up as an end in itself. It is easy to fall into the “empty scale-up” trap.

303K

number of women who died due to pregnancy or childbirth-related complications in 2015

5.9M

number of children under age 5 who died in 2015

47

percentage of all under-5 deaths that occurred during the first 28 days of life in 2015

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Where effective coverage is low, program efforts need to contribute to increasing and sustaining improved coverage. In some instances the interventions are already available and in use but at low effective coverage. In these cases improved delivery is needed – which may entail strengthened implementation or new delivery strategies. In situations where effective interventions are novel and not yet widely introduced, these methods may require some kind of scaling-up process to increase coverage. Because there are important differences between settings, a specific strategy or package will not be the answer for all settings.

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