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Title page 1

Contents 4

FOREWORD 5

ACKNOWLEDGEMENTS 7

ABBREVIATIONS 9

HIGHLIGHTS: Early Essential Newborn Care (EENC) 10

1. Introduction 12

Regional vision 12

Enhancing the quality of maternal and newborn care through sustainable systems 13

Planning for the next three years 14

2. Benchmarks of EENC scale-up readiness 15

3. Health facility EENC standards 18

EENC coaching and hospital teams 18

Routine antenatal and childbirth care practices 22

Immediate newborn care for term and PTLBW babies 24

Environmental hygiene at health facilities 28

4. Trends in core EENC indicators, 2017-2023 29

5. Tracking hospital impact 35

6. EENC intervention coverage and population impact 37

Population-based coverage 37

Impact indicators for newborn health 40

7. Qualitative findings: root cause analysis and actions to address 43

8. Recommendations 48

Recommendations for Member States 48

Recommendations for WHO 50

References 51

ANNEX 1. Early Essential Newborn Care (EENC) 55

ANNEX 2. EENC monitoring and evaluation framework, 2015-2030 60

ANNEX 3. Validation of EENC monitoring and evaluation data from seven priority countries 66

ANNEX 4. Population-based coverage indicators 71

ANNEX 5. EENC country profiles 73

Tables 21

TABLE 1. Health facilities that have introduced EENC and staff coached in these health facilities, by country, April 2024 21

TABLE 2. Population impact indicators, by country, 2023 41

TABLE 3. Key challenges related to the implementation and sustainability of EENC in six areas (A-F) 43

Figures 16

FIG. 1. Status of the EENC scale-up readiness benchmarks, by country, 2023 16

FIG. 2. Priority countries achieving EENC scale-up readiness benchmarks, 2017, 2019 and 2023 17

FIG. 3. Health facilities providing childbirth services that have introduced EENC, by country, 2017, 2020 and 2024 19

FIG. 4. Health facility staff coached in EENC, by country, 2017, 2019 and 2023 20

FIG. 5. Antenatal care and delivery practices by facility level, seven countries, 2022-2023 23

FIG. 6. SSC practices for term and PTLBW newborns, seven countries, 2022-2023 25

FIG. 7. Breastfeeding practices for term and PTLBW newborns, seven countries, 2022-2023 25

FIG. 8. SSC practices for term newborns born vaginally and by caesarean section, seven countries, 2022-2023 27

FIG. 9. Management of PTLBW newborns, seven countries, 2022-2023 27

FIG. 10. Handwashing facilities by room type, six countries, 2022-2023 28

FIG. 11. Number of countries and health facilities included across EENC implementation review rounds 29

FIG. 12. SSC practices for term and PTLBW newborns, 2017, 2019 and 2023 30

FIG. 13. Breastfeeding practices for term and PTLBW newborns, 2017, 2019 and 2023 32

FIG. 14. Routine newborn care practices for term newborns, 2017, 2019 and 2023 33

FIG. 15. Antenatal care and delivery practices, 2017, 2019 and 2023 34

FIG. 16. Population coverage for skilled birth attendance, facility delivery and caesarian section, nine countries, 2016-2023 39

FIG. 17. Neonatal mortality rates in nine countries implementing EENC, 2008, 2013, 2018 and 2023 42

Annex Tables 54

TABLE A1.1. Detailed EENC interventions for all mothers, including high-risk mothers and newborn infants 57

TABLE A1.2. Summary of the WHO regional approach to scaling up and sustaining EENC, 2015-2023 59

TABLE A2.1. Benchmarks of EENC scale-up readiness 60

TABLE A2.2. Health facility EENC standards 61

TABLE A2.3. Hospital impact indicators 63

TABLE A2.4. Coverage indicators for EENC interventions 64

TABLE A2.5. Impact indicators for newborn health 65

TABLE A3.1. Summary of the availability of data on EENC scale-up readiness benchmarks and validation status, by country, June 2024 66

TABLE A3.2. Summary of the availability of data on EENC facility standards and validation status, by country, June 2024 67

TABLE A3.3. Summary of the availability of data on EENC hospital impact indicators and validation status, by country, June 2024 68

TABLE A3.4. Summary of the availability of data on population coverage indicators and validation status, by country, June 2024 69

TABLE A3.5. Summary of the availability of data on impact indicators and validation status, by country, June 2024 70

Annex Figures 54

FIG. A4.1. Population coverage for skin-to-skin contact, early breastfeeding and exclusive breastfeeding from 0 to 28 days, nine countries, 2016-2023 71

FIG. A4.2. Population coverage for maternal and newborn postnatal care, nine countries, 2016-2023 72

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