Main findings
To our knowledge, this is the first study to use video recording to assess NR performance in secondary-level district hospitals in a resource-constrained setting. Our study found several deviations in the quality of care on all NR indicators assessed and low adherence to NR guidelines (table 4). Particularly NR performance for ventilation, which is the most important NR intervention, was suboptimal; it was not initiated within the first minute (or at all) in 55% of the cases, unsustained (or not performed at all) with frequent interruptions in 75% of the cases. Furthermore, other tasks not indicated by NR guidelines were being performed, such as vigorous suction, or in one-third of the time, no intervention were being performed.