A continuum of care to save newborn lives.

The global community recently declared a commitment to " create an environment—at the national and global levels alike—which is conducive to development and to the elimination of poverty ". 1 This declaration led to an agreement on eight goals in key areas of global concern: the Millennium Development Goals. Central among those goals are two that aim to reduce maternal and child mortality, goals 4 and 5. Investment in maternal, newborn, and child health is not only a priority for saving lives, but is also critical to advancing other goals related to human welfare, equity, and poverty reduction. 2 The United Nations has led the global community in articulating a rights-based approach to health, giving special attention to mothers and children. The Universal Declaration of Human Rights, ratified in 1948, states that " motherhood and childhood are entitled to special care and assistance ". 3 The Convention on the Rights of the Child, ratified in 1989, guarantees children's right to the highest attainable standard of health. 4 Other conventions and international consensus documents focus on redressing the gender-based discrimination that might undermine good health, particularly that of girls and women. Only collective responsibility and close coordination among governments, assistance agencies, and civil society will make achieving these goals possible. The challenge is significant. Each year: more than 60 million women without skilled care; 5 about 515000 women die from pregnancy-related complications; 6 almost 11 million children die before they reach the age of 5 years; 7 of children who die under the age of 5, 38% die in the first month of life, the neonatal period, and about three-quarters of neonatal deaths occur in the first week after birth; 8 and there are about 4 million stillbirths. 9 The socioeconomic consequences of maternal, newborn , and child morbidity and mortality are also significant. Many conditions, such as obstructed labour or preterm birth, can cause severe disabilities for survivors, adding stress to already fragile communities and health systems. A mother's death or illness can jeopardise an entire family's well-being; the care required for disabled or sick children burdens families; and the loss of current or future earnings exacerbates the cycle of poverty and poor health for families and societies. 10 The burden of maternal, newborn, and child mortality falls disproportionately on the world's poorest countries and on the poorest populations. Within most low-income countries, child mortality rates, for example, are several …