The purpose of this Quality Improvement initiative is to reduce severe morbidity and mortality among premature infants through proven and cost-effective clinical management during the antenatal, intrapartum, and postpartum periods. In order to reduce neonatal mortality and morbidity due to preterm birth complications, health facilities must be able to identify and manage women in preterm labor, accurately administer medications, and provide high-quality postnatal care.

The purpose of this Quality Improvement initiative is to reduce severe morbidity and mortality among premature infants through proven and cost-effective clinical management during the antenatal, intrapartum, and postpartum periods. In order to reduce neonatal mortality and morbidity due to preterm birth complications, health facilities must be able to identify and manage women in preterm labor, accurately administer medications, and provide high-quality postnatal care.

The study will provide evidence of implementing a package of clinical interventions coupled with quality improvement and monitoring strategy aimed at reducing neonatal mortality in 3 resource-limited health facilities, leveraging on an existing strengthened birth registry to provide neonatal outcomes up to 28 days after delivery. Additionally, using a multifaceted approach through an interdisciplinary team, the investigators will identify the social and cultural barriers that contribute to home-based deliveries. These findings will be helpful to the Ministry of Health in shaping future policies regarding the scale-up of newborn care clinical protocols as part of Government's efforts to reducing neonatal mortality in Zambia.

Inclusion Criteria:

• Pregnant women who seek Antenatal care services and plan to deliver in the selected health facilities
• Women who reside within the larger catchment area of the selected 3 health facilities

Exclusion Criteria:

• Women who reside outside the larger catchment area of the health facilities
• Women who have not sought antenatal care services in the 3 health facilities and have come to only deliver there

Pregnant women who seek antenatal care and delivery services at the selected 3 health facilities.

Pregnant women who seek antenatal care and delivery services at the selected 3 health facilities.

The study data will be shared upon a reasonable request to the study PI.

The data will be shared with the requesting investigator/entity.

For secondary analysis purposes or verification of publication results.