The countries in South-east Asia have wide disparities in socio-economic and health indicators. This region accounts for almost one-third of global mortality in neonates and children under 5 years of age, and many countries in the region are unlikely to attain Millennium Development Goal 4. Over the past decade, several countries have initiated innovative projects with the aim of improving child health. This paper examines the innovations in neonatal health in four countries - Bangladesh, India, Sri Lanka and Thailand - and analyses the extent to which these have been successful in meeting their goals. This case study will inform national governments and donor agencies wishing to scale up or modify existing neonatal health interventions. (C) 2011 Published by Elsevier Ltd on behalf of The Royal Society for Public Health.