P1.155: Readiness to Resuscitate Newborns at Birth in Secondary Health Facilities in South East Nigeria - A survey

Background: About 136 million babies are born annually, with an estimated 10% requiring some form of basic support at birth and 3–6% needing active resuscitation. Majority of the neonatal death occur in the sub-Saharan, about one fourth being due to intrapartum event. One of the most accountable causes of neonatal death is birth asphyxia of which early anticipation and effective resuscitation immediately after birth have a substantial contribution to preventing its occurrence. Effective neonatal resuscitation using a bag and mask has a substantial role in preventing neonatal morbidities and mortalities related to birth asphyxia. In the past one decade, there has been a substantial investment in neonatal resuscitation training in Nigeria, but the penetrance to privately and faith-based owned facility has not been studied. In view of this, the healthcare providers' preparedness and risk anticipation are pivotal life-saving interventions which was analyzed in this study.

Methods: A cross-sectional descriptive questionnaire based study of the maternal and child peripheral health facilities within the capital cities of four Eastern States in Nigeria. The health facilities were recruited via convenient sampling. Data collected were categorized and reported in percentages and ratio. The Chi-square analysis was used to assess initial associations between the predictor and outcome variables. Data analysis was done using Epi Info version 7.2 and statistical significance was set at P < 0.05.

Results: Seventy-seven health facilities located in four cities in southeast Nigeria were surveyed. Privately owned facility was (96.1%) while faith-based owned hospitals are 3.9%. Forty-nine (63.6%) of the hospital were owned by medical doctors who are specialist in obstetrics, 25 (32.5%) owned by doctors who are unspecialized general practitioners and the remainder 3 (3.9%) are owned by non-doctors. The median annual birth rate of these facilities was approximately 120 (IQR 30 – 300). 94.8% had area for resuscitation, 29.9% had radiant warmer, 75.4% had ventilation bag for resuscitation, 93.5% had available oxygen source and 100% had hand washing area. 26% of the health facilities staff with no formal training on resuscitation and 33.6% of the facilities had poor resuscitation preparedness score.

Conclusion: Preparedness for resuscitation in the surveyed facilities was suboptimal as a 1/3rd of the facilities surveyed had poor scores. It can be inferred that babies born in those facilities that need resuscitation may not get optimal care, therefore the need to change the focus of neonatal resuscitation training to include the privately and faith-based owned facilities as this will improve neonatal health indices in Nigeria.