Coverage of the WHO’s four essential elements of newborn care and their association with neonatal survival in southern Nepal

Despite recent improvements in child survival, neonatal mortality continues to decline at a slower rate and now represents 47% of under-five deaths globally. The World Health Organization developed core indicators to better monitor the quality of maternal and newborn health services.

One such indicator for newborn health is “the proportion of newborns who received all four elements of essential care”. The four elements are immediate and thorough drying, skin to skin contact, delayed cord clamping, and early initiation of breastfeeding.

Although there is existing evidence demonstrating an association with decreased neonatal mortality for each element individually, the cumulative impact has not yet been examined.