First embrace, lasting progress: newborn care reaches 6500 facilities across the Western Pacific

The “first embrace” – immediate skin-to-skin contact – between a mother and her newborn can be life saving. Two new publications now show just how much Early Essential Newborn Care (EENC), developed by the World Health Organization (WHO), has helped transform newborn and maternal care across the WHO Western Pacific Region for over a decade. 

Since 2013, EENC has been introduced in approximately 6500 childbirth facilities across nine priority countries in the Region, while more than 42 500 health-care providers have received practical coaching. In 2023 assessments of EENC-implementing facilities, nearly 93% of full-term newborns received immediate skin-to-skin contact. 

Behind those figures is a profoundly human moment: a baby kept warm and calm on the mother's chest, a mother supported to initiate early and exclusive breastfeeding, and a family able to stay together at the start of life.

A decade of healthy starts

Two new publications document how this change was achieved and what remains to be done. The WHO report Early Essential Newborn Care: Fourth Progress Report (2022-2023) charts regional milestones and remaining gaps, while the peer-reviewed article “Early essential newborn care: a decade of scaling up quality, life-saving interventions across East Asia and the Pacific (2013-2023)”, published in BMJ Global Health in June 2026, explains how countries achieved change at scale. 

Together, these two publications describe how proven guidance can become everyday care that keeps babies warm, supports early and exclusive breastfeeding, and helps mothers and newborns stay together from the first moments of life.

EENC-implementing countries by year of implementation. 

^{PHL: Philippines; KHM: Cambodia; LAO: Lao People’s Democratic Republic; MNG: Mongolia; PNG: Papua New Guinea; SLB: Solomon Islands; CHN: China; VNM: Viet Nam; VUT: Vanuatu.}

Health facility staff coached in EENC, by country, 2010–2023. Source: estimated total number of health staff (hospitals and primary care facilities) coached in EENC from country programme reports, 2010–2023. 

Health facilities providing childbirth services that have introduced EENC (%), by country, 2015–2023. Source: proportion of estimated total number of facilities providing birth services (hospitals and primary care facilities) introducing EENC from country programme reports 2015–2023

The progress comes as newborn deaths remain an urgent challenge. In 2022, 100 585 newborns died in the Western Pacific Region – amounting to one newborn death every five minutes. Prematurity, complications during birth and infections remain among the leading causes. 

At the heart of EENC is the First Embrace: immediate and sustained skin-to-skin contact between mother and baby. Along with immediate drying, delayed cord clamping, and support for breastfeeding when the baby is ready, it helps protect newborns in the first minutes and hours when they are most vulnerable. EENC also includes resuscitation for babies who do not breathe at birth and Kangaroo Mother Care for preterm and low-birthweight babies.

“What happens in the first moments after birth can shape a newborn’s chances of surviving and thriving. Simple, proven practices help keep a newborn warm and calm on the mother’s chest, and support a mother to begin breastfeeding,” said Dr Huong Tran, Director, Division of Health Promotion, Disease Prevention and Control, WHO Regional Office for the Western Pacific. “Countries have proven that these practices can transform care at scale when health workers have the support and systems to deliver them consistently.”

The two publications show that more babies who might once have been separated from their mothers are now receiving care that keeps them together. By 2023, nearly three in four babies born by caesarean section in assessed facilities received immediate skin-to-skin contact. Among preterm and low-birthweight babies weighing 2000 grams or less, 56% received Kangaroo Mother Care, compared with 7% in 2015.

From evidence-based guidance to everyday care 

Rather than relying on one-off classroom training, EENC uses small-group, on-the-job coaching right in the settings where health workers deliver care. Multidisciplinary hospital teams identify practical barriers – from how a delivery room is organized to whether operating-theatre procedures allow mother and baby to stay together – and use facility data to track whether changes are working.

“Skin-to-skin contact may seem simple, but making it possible after every birth requires the preparation, commitment and dedication across the entire childbirth care team. EENC brought learning directly into the delivery room,” said Dr Delgermaa Vanya, Technical Officer, Maternal, Newborn and Child Health unit, WHO Regional Office for the Western Pacific. “Through hands-on coaching, teamwork and the use of facility data, health workers could identify obstacles and improve routine practices. That is how evidence-based guidance becomes everyday practice.”

Of the nine implementing countries, five have already reached the regional target of introducing EENC in at least 80% of childbirth facilities, and three more are on track. The publications describe EENC as the largest regional collaboration globally to improve the quality of newborn care. 

The next challenge is to make these improvements universal and fully institutionalized. WHO is working with countries to build EENC into the education of future health workers, strengthen regular monitoring of care and support country-led quality improvement. The goal is straightforward: every mother supported, every health worker prepared and every newborn given a healthy start.

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Notes to editors:

• Early Essential Newborn Care is a package of simple, evidence-based and cost-effective practices delivered during labour, birth and the early newborn period. Its core First Embrace practices include immediate and thorough drying, immediate and uninterrupted skin-to-skin contact, delayed cord clamping and support for breastfeeding in response to the baby's cues.
• The nine priority countries are Cambodia, China, the Lao People's Democratic Republic, Mongolia, Papua New Guinea, the Philippines, Solomon Islands, Vanuatu and Viet Nam. Together, they account for 95% of newborn deaths in the Western Pacific Region.
• Figures on skin-to-skin contact, caesarean births and Kangaroo Mother Care are drawn from facility assessments reported in the publications and should not be interpreted as population-wide coverage in every country.