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