Neonatal resuscitation: an observational study assessing the readiness of service providers in Nepal

Abstract

A significant proportion of neonatal mortality, a major public health challenge in low- and middle-income countries, can be attributed to intrapartum-related hypoxic events. This study seeks to assess the determinants of health care providers’ competence in providing newborn resuscitation. A cross-sectional survey of 154 health facilities in Nepal was done. This nested study evaluated the newborn resuscitation knowledge and skills of 462 health care providers by individually assessing a delivery using a 22-item clinical practice observation tool and administering the standard 18-item Helping Babies Breathe Knowledge Check Significant predictors of provider knowledge included: province (0.085 points higher in Bagmati province, p=0.018); mean availability of essential utilities and resuscitation aids (0.173 points, p<0.001 and 0.187, p= 0.02 respectively); participation in – Latter-day Saint Charities – Safa Sunaulo Nepal (LDSC/SSN) newborn resuscitation training, scale-up and skill retention program (0.676 units higher, p<0.001); and qualifications (0.136 points higher among health providers with Bachelor of Nursing degree, p<0.001, 0.072 points higher among providers with Masters in Nursing degree, p= 0.010 and 0.110 units higher among providers with Senior Auxiliary Nursing Midwife degree,, p=0.001). Significant factors associated with resuscitation skill included province (0.056 units higher in province 1, p= 0.015 and 0.037 units higher in Sudurpaschim province, p=0.034); delivery caseload (0.066 units higher mean skill score in health facilities with average monthly delivery of more than 120, p= 0.011); availability of newborn resuscitation practice aids (0.093 units higher score in health facilities with resuscitation practice aids, p= 0.008); and participation in LDSC/SSN newborn resuscitation training, scale-up and skill retention program (0.968 units, p< 0.001). Participation in the LDSC/SSN’ skill retention program was the best predictor of newborn resuscitation knowledge and skills. The LDSC/SSN model of newborn resuscitation training, scale up and skill retention could be one potential cost-effective model to address gaps in resuscitation knowledge and skills among service providers.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

The authors received no specific funding for this work.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval from the study was approved from the Nepal Health Research Council with registration number 236/2022 P.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.

Yes

Data Availability

All data underlying the findings are provided as part of the submitted article.

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