In the past few decades, global guidance has encouraged women to deliver in health facilities. As a result, many countries have documented large increases in the number of facility-based deliveries. Unfortunately, this increase has not been matched with improvements in maternal and newborn survival because childbirth at a health facility doesn’t ensure that care will be of good quality. High quality maternal and newborn health care depends upon health worker knowledge, practices, and attitudes and the availability of proper supplies, equipment, and medicines. Evidence suggests that barriers to providing high quality of care in a health facility on the day of birth are exacerbated in conflict-affected contexts. A first step to improve maternal and newborn care is to examine challenges in providing high quality care and identify solutions that respond to the unique circumstances of facility-based care in these settings.