Summary of WHO Standards for Newborn Quality Improvement: Part 2.

The health information system enables collection, analysis and use of data to ensure early appropriate action to improve the care of every small and sick newborn.

Quality statements

2.1 Every small and sick newborn has a complete, accurate, standardized, up-to-date medical record, which is accessible throughout their care, on discharge and on follow-up.

2.2 Every health facility has a functional mechanism for collecting, analyzing and using data on newborns as part of monitoring performance and quality improvement.

2.3 Every health facility has a mechanism for collecting, analyzing and providing feedback on the newborn services provided and the perceptions of families of the care received.


Every small and sick newborn with a condition or conditions that cannot be managed effectively with available resources receives appropriate, timely referral through integrated newborn service pathways with continuity of care, including during transport.

Quality statements

3.1 Every small and sick newborn who requires referral receives appropriate pre-referral care, and the decision to refer is made without delay.

3.2 Every small and sick newborn who requires referral receives seamless, coordinated care and referral according to a plan that ensures timeliness.

3.3 For every newborn referred or counter-referred within or between health facilities, there is appropriate information exchange and feedback to relevant health care staff.

3.4 Every health facility that provides care for small and sick newborns has been designated according to a standard level of care and is part of an integrated newborn network with clear referral pathways, a coordinating referral centre that provides clinical management support, protocols and guidelines.

3.5 Newborn transfer services provide safe, efficient transfer to and from referral neonatal care by experienced, qualified personnel, preferably specialist transport teams, in specialist transport vehicles.

3.6 Every newborn who requires referral is transferred in the kangaroo mother care position with their mother, when possible.


Communication with small and sick newborns and their families is effective, with meaningful participation, and responds to their needs and preferences, and parental involvement is encouraged and supported throughout the care pathway.

Quality statements

  • 4.1 All careers of small and sick newborns are given information about the newborn’s illness and care, so that they understand the condition and the necessary treatment.
  • 4.2 All small and sick newborns and their careers experience coordinated care, with clear, accurate information exchange among relevant health and social care professionals and other staff.
  • 4.3 All careers are enabled to participate actively in the newborn’s care through family-centered care and kangaroo mother care, in decision-making, in exercising the right to informed consent and in making choices.
  • 4.4 Careers of small and sick newborns and staff understand the importance of nurturing

interaction with the newborn, recognize and respect the newborn’s behavior and cues, and

include them in care decisions.

  • 4.5 All careers receive appropriate counselling and health education about the current illness of the newborn, transition to kangaroo mother care follow-up, community care and continuous care, including early intervention and developmental follow-up.
  • 4.6 In humanitarian and fragile settings, including outbreak and pandemic situations, special consideration is given to the specific psychosocial and practical needs of small and sick newborns and their careers.


Newborns’ rights are respected, protected and fulfilled without discrimination, with preservation of dignity at all times and in all settings during care, transport and follow-up.

Quality statements

  • 5.1 All newborns have equitable access to health care services, with no discrimination of any kind.
  • 5.2 The careers of all newborns are made aware of and given information about the newborn’s rights to health and health care.
  • 5.3 All newborns and their careers are treated with respect and dignity, and their right to privacy and confidentiality is respected.
  • 5.4 All newborns are protected from any physical or mental violence, injury, abuse, neglect or any other form of maltreatment.
  • 5.5 All newborns have their birth registered and have an identity.
  • 5.6 All newborns who die and all stillbirths have their death registered.


All small and sick newborns are provided with family-centred developmental supportive care and follow-up, and their families receive emotional and psychosocial support that is sensitive to their needs and strengthens their capability.

Quality statements

  • 6.1 All small and sick newborns stay with their careers, with minimal separation, and the role of careers is recognized and supported at all times during care, including rooming-in during hospitalization.
  • 6.2 All newborns born preterm or with a low birth weight receive kangaroo mother care as soon as possible after birth, and the parents are supported in its provision.
  • 6.3 All small and sick newborns receive appropriate developmental supportive care, and their families are recognized as partners in care.
  • 6.4 All families receive care in an environment in which their socioeconomic, emotional and cultural needs are respected and supported.
  • 6.5 All small and sick newborns receive appropriate, coordinated developmental follow-up with minimal disruption to family life and routines.

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