In this study in rural Nepal, 23,662 newborn infants were enrolled in a community-based trial assessing the effect of skin and/or umbilical cord cleansing with chlorhexidine on neonatal mortality through 28 days of life. The study showed that birth attendant hand washing was related to a statistically significant lower mortality rate among neonates (adjusted relative risk [RR]=0.81), as was maternal hand washing (adjusted RR=0.56). There was a 41% lower mortality rate among neonates exposed to both hand-washing practices (adjusted RR=0.59). Arch Pediatr Adolesc Med. 2008;162(7):603-608.