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This framework was developed in consultation with the Newborn Resuscitation Working Group of the Newborn Technical Reference Team of the United Nations Commission on Life-Saving Commodities (UNCoLSC). It highlights common health system and quality of care gaps impeding provision of life-saving basic newborn resuscitation services in low-resource settings and describes how quality improvement and health system strengthening approaches can help overcome these gaps. It is intended to help managers and skilled birth attendants at all system levels to understand common quality gaps and promising approaches for improving newborn resuscitation services as one element of a broader package of essential services for newborns.