Neonatal Resuscitation in Some Nigerian Primary and Secondary Health Institutions: an Evaluation of Ongoing Practices.

Abstract

Background: Birth asphyxia is an important cause of neonatal morbidity and mortality all over the world and especially in developing nations. Therefore, it is necessary to ascertain if birth attendants have the requisite knowledge, equipment and skills for effective resuscitation of newborns. Objectives: To evaluate the knowledge and ongoing practices of newborn resuscitation at the primary and secondary health care levels in Nigeria, so as to suggest ways of improvement. Design: Cross-sectional questionnaire and facility inspection study. Participants: Midwives and other birth attendants in 10 primary and two secondary health care facilities in Osun state. Methods: Structured questionnaires eliciting details of available equipment and drugs, training, length of experience, knowledge and practices of birth attendants on infant resuscitation were administered to all the birth attendants on duty in 12 health care facilities. Results: There were 170 respondents; 113 (66.5 percent) at primary and 57 (33.5 percent) at secondary health care levels. Basic resuscitating equipment was lacking in all, but the situation was worse at the primary level. Ambu-bagging and endotracheal intubation were rarelypractised. There were significantly greater use of vigorous stimulation (p<0.012), administration of nikethamide and methylated spirit (p <0.005) and less frequent administration of oxygen (p<0.005) in the primary than secondary level health facilities. Conclusions: The knowledge and skill of birth attendants at primary and secondary health care levels were inadequate and should be upgraded