The provision of high-quality care to sick newborns presents challenges in any health system. International guidelines suggest that even for babies who do not require intensive care, there should be one nurse for every 2 – 4 sick babies. However, recent studies conducted in Nairobi show that one nurse takes care of between 20 – 40 newborns. In a recently published policy brief the KEMRI Wellcome Trust programme highlights the experience of nurses in Nairobi’s New Born Units.