**Abstract**

The survival of preterm babies has significantly improved over the last several decades in the high-income countries because of the availability of Neonatal Intensive Care Units (NICU's) in both large and small hospitals, presence of specially trained physicians, nurses, and other health care personnel with easy access to sophisticated equipment. However, the bigger public health advances that saw improvements in socio-economic status of the populations, improvements in education and sanitation conditions and reductions in malnutrition and rates of infectious diseases were probably the main reasons for this improved survival rates for preterm neonates. Low in-come countries are currently highest bearers of the burden of preterm morbidity and mortality. The current preventive and care interventions do not reach all the neonates and their mothers, the coverage has remained low, access is poor and the quality of care is low. The aim of this chapter is to propose ideas on how the current preterm neonatal care interventions can be adapted for community scale up through community-based health system structures like community health workers to improve survival of neonates who have been delivered from home or after they have been discharged from hospital.

**Keywords:** preterm, communities, low in-come countries, access, coverage
