newborns: no longer going unnoticed 87 The improvement of coverage to underserved communities is likely to prove a majo challenge to many resource-poor countries for years to come The second problem is that the training of professional health workers who attend childbirth and the focus of their work have often been directed almost exclusively towards the safety of the mother at the moment of childbirth itself, to the neglect of the newborn and the critical week after the birth(31). Newborn care is part of the riculum and responsibility of midwives, nurse-midwives and the doctors who function as their equivalents, but in practice many of these professionals do not get the training r experience to ensure that they are competent to carry out all of the key procedures for newborns In Benin, Ecuador, Jamaica and Rwanda, for example only 57% of all doctors, midwives, nurses and medical interns who routinely assist at births lately tested ( 32). Alth the technology that is needed is actually quite simple and inexpensive, health workers can be unsure of how to deal with the sudden complications that may become life-threatening in a couple of hours, and ally even less readily available than they are for the care a mother may need in case of complications. Even within a hospital, the back-up services for maternal and neonatal care that should be triggered when a com plication arises are often not organized quickly enough; hospitals may not be set up to care for newborns in terms of staff training and equipment. Giving birth in a health facility(not necessarily a hospital) th professional staff is safer by far than doing so at home. But the same environ- ment that makes for a safer birth also may put newborns at increased risk of iatrogenic infections, overmedicalization and inappropriate hospital practices. In all too many hospitals, mother and baby may be separated, which makes it diffi cult for mothers to bond with and provide warmth to their newborns, Babies born in hospitals in some settings are actu- ally less likely to be breastfed than those rn elsewhere (33). Maximizing synergies between mater. nal and neonatal health will require birth- ing facilities to give special attention to appropriate training of staff and the orga- nization of care that takes account of the needs of the newborn Facilities will also need to improve infection control, keep medical interventions to a minimum and Professional care for newboms is often hard to getnewborns: no longer going unnoticed 87 The improvement of coverage to underserved communities is likely to prove a major challenge to many resource-poor countries for years to come. The second problem is that the training of professional health workers who attend childbirth and the focus of their work have often been directed almost exclusively towards the safety of the mother at the moment of childbirth itself, to the neglect of the newborn and the critical week after the birth (31). Newborn care is part of the cur￾riculum and responsibility of midwives, nurse-midwives and the doctors who function as their equivalents, but in practice many of these professionals do not get the training or experience to ensure that they are competent to carry out all of the key procedures for newborns. In Benin, Ecuador, Jamaica and Rwanda, for example, only 57% of all doctors, midwives, nurses and medical interns who routinely assist at births were able to resuscitate a newborn adequately when their skills were tested (32). Although the technology that is needed is actually quite simple and inexpensive, health workers can be unsure of how to deal with the sudden complications that may become life-threatening in a couple of hours, and essential drugs and equipment are usu￾ally even less readily available than they are for the care a mother may need in case of complications. Even within a hospital, the back-up services for maternal and neonatal care that should be triggered when a com￾plication arises are often not organized quickly enough; hospitals may not be set up to care for newborns in terms of staff training and equipment. Giving birth in a health facility (not necessarily a hospital) with professional staff is safer by far than doing so at home. But the same environ￾ment that makes for a safer birth also may put newborns at increased risk of iatrogenic infections, overmedicalization and inappropriate hospital practices. In all too many hospitals, mother and baby may be separated, which makes it diffi- cult for mothers to bond with and provide warmth to their newborns. Babies born in hospitals in some settings are actu￾ally less likely to be breastfed than those born elsewhere (33). Maximizing synergies between mater￾nal and neonatal health will require birth￾ing facilities to give special attention to appropriate training of staff and the orga￾nization of care that takes account of the needs of the newborn. Facilities will also need to improve infection control, keep medical interventions to a minimum, and Professional care for newborns is often hard to get. P. Virot/WHO