<p>Globally, neonatal mortality rates remain relatively stagnant despite overall progress in reducing under-5 mortality. In regions with highest mortality for neonates, infections account for up to 30%-50% of deaths. In many low and middle income countries (LMICs), births within health care facilities are encouraged as a mechanism to reduce both maternal and neonatal mortality. However, the resulting increased demand for facility births has not been accompanied by comparable increases in capacity for delivering quality care and enhancing the safety of maternal and neonatal patients. Shortages in space, trained staff, and consumable resources have frayed many maternal-neonatal health care settings. To date, there have been limited systematic efforts to improve quality of care, while demands on facilities expand.</p>