The reduction in global neonatal mortality rates remains a
challenge. Internationally recognized protocols for hospital
care of sick and small newborns are limited, although this
specialized area lends itself to standardization. An interdisciplinary
team including international and local clinical experts
worked with the Rwandan Ministry of Health and
Rwandan professional associations to develop and implement
a neonatal care program in a rural Rwandan district
hospital that was ultimately accepted as the national standard
for newborn medicine. Successful features and challenges
are discussed. It is realistic to develop, implement
and disseminate neonatal protocols for sick newborns.