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      Assessing Midwives' Knowledge and Practice in Neonatal Resuscitation: Gaps and Transfer of Knowledge to Reduce Mortality

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          Abstract

          Introduction

          The neonatal period is a crucial time for the survival, growth, and development of newborns. Despite advances in medical science, neonatal mortality rates remain a significant public health issue, and midwives play a critical role in reducing neonatal deaths through the use of evidence-based practices and appropriate neonatal resuscitation techniques. However, studies have shown that healthcare workers, including midwives, may not possess adequate knowledge in neonatal resuscitation, leading to adverse outcomes. This study aims to explore the current state of neonatal care and the role of midwives in neonatal resuscitation, with a focus on training and the transfer of knowledge into practice. It is essential to assess the level of knowledge of midwives in neonatal resuscitation and their ability to transfer this knowledge into action to reduce neonatal mortality rates.

          Objectives

          The objective of this study was to assess the level of knowledge and practice of midwives in neonatal resuscitation, identify gaps in their knowledge and practice, and evaluate their ability to transfer this knowledge into action to reduce neonatal mortality rates.

          Methods

          This study is a cross-sectional, descriptive study conducted in six governmental teaching hospitals located in Khartoum city, with a total sample size of 57 midwives who work in the labor and operation rooms of the hospitals. The questionnaire comprised sections on sociodemographics (5 questions), knowledge assessment (14 questions), and neonatal resuscitation practices (21 questions). The sampling technique used was total coverage.

          Result

          This study included 57 female participants, primarily aged 51–60 years with a one-year diploma level of education. Of those surveyed, 49.1% performed neonatal resuscitation weekly. Participants demonstrated strong knowledge and practice in preparing for birth, but some gaps were identified in equipment usage and identification band placement. Resuscitation skills were generally lacking, with poor performance in ambo bagging and chest compression.

          Conclusion

          This study on Sudanese midwives' neonatal resuscitation knowledge and practices reveals room for improvement in equipment use, identification, and resuscitation skills. Demographic factors affect CPR knowledge and practice.

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          Most cited references23

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          4 million neonatal deaths: when? Where? Why?

          The proportion of child deaths that occurs in the neonatal period (38% in 2000) is increasing, and the Millennium Development Goal for child survival cannot be met without substantial reductions in neonatal mortality. Every year an estimated 4 million babies die in the first 4 weeks of life (the neonatal period). A similar number are stillborn, and 0.5 million mothers die from pregnancy-related causes. Three-quarters of neonatal deaths happen in the first week--the highest risk of death is on the first day of life. Almost all (99%) neonatal deaths arise in low-income and middle-income countries, yet most epidemiological and other research focuses on the 1% of deaths in rich countries. The highest numbers of neonatal deaths are in south-central Asian countries and the highest rates are generally in sub-Saharan Africa. The countries in these regions (with some exceptions) have made little progress in reducing such deaths in the past 10-15 years. Globally, the main direct causes of neonatal death are estimated to be preterm birth (28%), severe infections (26%), and asphyxia (23%). Neonatal tetanus accounts for a smaller proportion of deaths (7%), but is easily preventable. Low birthweight is an important indirect cause of death. Maternal complications in labour carry a high risk of neonatal death, and poverty is strongly associated with an increased risk. Preventing deaths in newborn babies has not been a focus of child survival or safe motherhood programmes. While we neglect these challenges, 450 newborn children die every hour, mainly from preventable causes, which is unconscionable in the 21st century.
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            No cry at birth: global estimates of intrapartum stillbirths and intrapartum-related neonatal deaths.

            Fewer than 3% of 4 million annual neonatal deaths occur in countries with reliable vital registration (VR) data. Global estimates for asphyxia-related neonatal deaths vary from 0.7 to 1.2 million. Estimates for intrapartum stillbirths are not available. We aimed to estimate the numbers of intrapartum-related neonatal deaths and intrapartum stillbirths in the year 2000. Sources of data on neonatal death included: vital registration (VR) data on neonatal death from countries with full (> 90%) VR coverage (48 countries, n = 97,297); studies identified through literature searches (> 4000 abstracts) and meeting inclusion criteria (46 populations, 30 countries, n = 12,355). A regression model was fitted to cause-specific proportionate mortality data from VR and the literature. Predicted cause-specific proportions were applied to the number of neonatal deaths by country, and summed to a global total. Intrapartum stillbirths were estimated using median cause-specific mortality rate by country (73 populations, 52 countries, n = 46,779) or the subregional median in the absence of country data. Intrapartum-related neonatal deaths were estimated at 0.904 million (uncertainty 0.65-1.17), equivalent to 23% of the global total of 4 million neonatal deaths. Country-level model predictions compared well with population-based data sets not included in the input data. An estimated 1.02 million intrapartum stillbirths (0.66-1.48 million) occur annually, comprising 26% of global stillbirths. Intrapartum-related neonatal deaths account for almost 10% of deaths in children aged under 5 years. Intrapartum stillbirths are a huge and invisible problem, but are potentially preventable. Programmatic attention and improved information are required.
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              Neonatal Mortality

              (2019)
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                Author and article information

                Contributors
                Journal
                Nurs Res Pract
                Nurs Res Pract
                nrp
                Nursing Research and Practice
                Wiley
                2090-1429
                2090-1437
                2024
                11 July 2024
                : 2024
                : 6636506
                Affiliations
                1 deptDepartment of Pediatrics deptFaculty of Medicine eduOmdurman Islamic University , Khartoum, Sudan
                2 deptAnatomy Department deptFaculty of Medicine eduUniversity of Khartoum , Khartoum, Sudan
                Author notes

                Academic Editor: Majed Alamri

                Author information
                https://orcid.org/0009-0000-6360-4563
                https://orcid.org/0000-0003-0655-3653
                https://orcid.org/0000-0002-2600-9666
                Article
                10.1155/2024/6636506
                11257753
                39027130
                b3e1ef4f-c08e-4d68-b02f-3681b212b08a
                Copyright © 2024 Mohamed Abdualgafar Osman Mohamedsharif et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 June 2023
                : 24 June 2024
                : 29 June 2024
                Categories
                Research Article

                Nursing
                Nursing

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