Introduction
Approximately 2.5 million newborns die in the neonatal period, and most of these deaths are preventable by effective interventions delivered during the whole continuum of care during antenatal, intrapartum, childbirth and post-natal care. 1 2 Additionally, 2.6 million stillbirths occur annually, half of these intrapartum.3-6 Most of the mortality occurs in low and middle-income countries (LMIC). 7 84 The 2030 Sustainable Development Goals (SDG 3.2) sets a target of less than 12 neonatal deaths per 1000 live births. However, current global projections are not on track to attain the 2030 SDG target. 7 9 10
Neonatal mortality is greatest in the first 24 hours of life, where approximately 36% of mortalities occur. 3 5 An estimated 73% of neonatal deaths occur within the first week of life.3 5 The leading causes of neonatal death are intrapartum-related events (previously birth asphyxia), infections, and preterm birth complications. 3 7 11 12 What happens immediately after birth can affect an entire life course. 13 14 Positive pressure ventilation (PPV) is the key component of neonatal resuscitation, as 10% of newborns fail to initiate and sustain adequate breathing at birth.15-20 Neonatal resuscitation programmes (NRP) such as Helping Babies Breathe (HBB) can reduce intrapartum-related stillbirths and early neonatal mortality but focus on the whole continuum of reproductive, maternal, and newborn care is needed to increase overall neonatal survival. 14 21-23
The quality of NR in LMIC and translation of knowledge into clinical practice remains a challenge. 13 14 20 Video recording has been used to evaluate health workers (HW) neonatal resuscitation (NR) performance and adherence to guidelines, primarily in high-resource settings, with a few recent studies from tertiary hospitals in LMIC.20 24-32 Our feasibility study supported that video can be used to understand gaps in quality of care in NR in this context.33
This study aimed to assess the quality of neonatal resuscitation in four secondary health facilities in Pemba, Zanzibar, through video recordings and identify potential areas for improvement