The Golden Hour - Implementing and evaluating a package of interventions to improve newborn care in the first hour of life in a public sector hospital in Zimbabwe.

In a high-volume maternity unit at Sally Mugabe Central Hospital, Zimbabwe, Golden Hour care achieved sustained uptake of delayed cord clamping (81.1%) and early skin to skin care (76.1%) over 12 months.

• Why it matters: Neonatal mortality progress has stalled in low-resource settings, and evidence-based practices like DCC and ESSC are inconsistently implemented due to staffing and infrastructure constraints.
• What they did: A context-specific quality improvement bundle was co-designed with maternity staff, using multidisciplinary training, embedded clinical support, leadership engagement, equipment provision, and Neotree digital tracking over November 2024–October 2025.
• The result: Among 15,292 eligible infants, DCC and ESSC were sustained at 82–91% and 72–85% for the final seven months, with PDSA cycles improving uptake in low birthweight and caesarean births and a non-significant trend toward lower crude mortality.

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