Childhood illness and mortality in Nepal: Trends and determinants. DHS Further Analysis Reports No. 120. 26. Lancet Series: Neonatal Survival (2005), Stillbirths (2011), Every Newborn (2014), Stillbirths (2016). 27. UNICEF (2021) Child survival and the SDGs. 28. Goudar SS, Somannavar MS, Clark R, Lockyer JM, Revankar AP, et al. (2013) Stillbirth and newborn mortality in India after helping babies breathe training. Pediatrics 131: e344-e352. 29. Bang A, Bellad R, Gisore P, Hibberd P, Patel A, et al. (2014) Implementation and evaluation of the Helping Babies Breathe curriculum in three resource limited settings: Does Helping Babies Breathe save lives? A study protocol. BMC Pregnancy Childbirth 14: 116. 30. Musafili A, Essén B, Baribwira C, Rukundo A, Persson LA (2013) Evaluating Helping Babies Breathe: Training for healthcare workers at hospitals in Rwanda. Acta Paediatrica 102: e34-e38. 31. Barker PM, Reid A, Schall MW (2015) A framework for scaling up health interventions: Lessons from large-scale improvement initiatives in Africa. Implement Sci 11: 12. 32. Westerlund A, Nilsen P, Sundberg L (2019) Implementation of implementation science knowledge: The researchpractice gap paradox. Worldviews Evid Based Nurs 16: 332-334. 33. Asish KC, Peterson SS, Gurung R, Skalkidou A, Gautam J, et al. (2021) The perfect storm: Disruptions to institutional delivery care arising from the COVID-19 pandemic in Nepal. J Glob Health 11: 05010. (2016) Reducing perinatal mortality in Nepal using helping babies breathe. Pediatrics 137: e20150117. 9. Msemo G, Massawe A, Mmbando D, Rusibamayila N, Manji K, et al. (2013) Newborn mortality and fresh stillbirth rates in Tanzania after helping babies breathe training. Pediatrics 131: e353-e360. 10. Versantvoort JMD, Kleinhout MY, Ockhuijsen HDL, Bloemenkamp K, de Vries WB, et al. (2020) Helping babies breathe and its effects on intrapartum-related stillbirths and neonatal mortality in low-resource settings: A systematic review Almost four million births occur in the United States each year. Ensuring the health and wellbeing of these infants is essential to the country’s vitality and to future generations. Given that the quality of medical and surgical care is of central importance to a newborn’s early chances, it might be expected that neonatal health care and outcomes are measured routinely. With some notable exceptions, this is not true. Overall, we know far less about health care for newborns than for any other patient group. This Dartmouth Atlas report provides a comprehensive description of populationbased patterns of newborn care across regions and hospitals for four large U.S. newborn populations: the U.S. total birth cohort, the Medicaid-insured newborns of Texas, and newborns insured by Anthem Blue Cross Blue Shield commercial and Medicaid plans. Population-based analyses start with an entire newborn population, not selected by health status or place of care. From this study population, medical care utilization of both mildly and very ill newborns is measured across all hospitals, regardless of whether care was provided in a neonatal intensive care unit. Similar analyses are also included from a groundbreaking report1 of Norwegian newborns, who share a high degree of socioeconomic and racial/ethnic similarity and receive care in a tightly organized national health service that offers services equitably to all. A Report of the Dartmouth Atlas Project 2 DARTMOUTH ATLAS OF NEONATAL INTENSIVE CARE The Vermont-Oxford Network Established as a not-for-profit research collaborative of neonatal intensive care units (NICUs) in 1988, the Vermont Oxford Network (VON) includes over 1,200 hospitals worldwide committed to improving NICU care through quality improvement efforts, education, and research. Individual centers voluntarily submit clinical data including patient characteristics, interventions, and outcomes, primarily during the NICU stay. Originally, VON collected data on very low birth weight newborns (401-1,500 grams or 22-29 weeks gestation) admitted to a member unit. Today, over half of VON members report data on all NICU admissions. Some members also report health and developmental data for extremely low birth weight infants at 18 to 24 months. VON data collection uses standardized definitions with numerous quality controls. VON members receive reports of risk-adjusted performance measures for their own unit compared to anonymous peer NICUs. The VON also offers opportunities to participate in quality improvement collaboratives at the local, regional, or health system levels. Population-based Newborn Studies This Dartmouth Atlas report uses several types of population-based data to measure and understand newborn care. In this approach, an entire newborn population is identified (i.e., the U.S. birth cohort or Anthem-insured newborns) and care is measured from birth forward. Population-based studies have a number of distinct strengths and weaknesses. A primary weakness compared to member-based collaboratives (e.g., the Vermont-Oxford Network or the California Perinatal Quality Care Collaborative (CPQCC)) is that the datasets generally rely on information collected for vital records (birth and death certificates) and billing purposes (insurance claims). Some relevant clinical data is not included, and the