Neonatal resuscitation capacity in Nepal

Area of Science:

• Global Health
• Neonatal Medicine
• Public Health Policy

Background:

• Perinatal asphyxia is a leading cause of neonatal deaths globally, particularly in resource-limited settings.
• Effective neonatal resuscitation requires trained personnel and adequate equipment.
• Nepal faces high neonatal mortality rates, with limited data on resuscitation capacity.

Purpose of the Study:

• To assess and quantify the availability of neonatal resuscitation resources at birthing facilities in Nepal.
• To identify disparities in resuscitation capacity between urban and rural settings and different levels of care.

Main Methods:

• A cross-sectional evaluation of 17 diverse birthing centers in Nepal, from tertiary hospitals to rural health posts.
• Standardized interviews with healthcare workers and direct assessment of newborn resuscitation areas.
• Systematic recording of essential resuscitation equipment availability.

Main Results:

• Variable availability of key resuscitation tools, including algorithms (45%), infant warmers (72%), mechanical suction (91%), and bag-mask devices (82%), among facilities with on-site deliveries.
• Tertiary care hospitals demonstrated significantly better equipment provision compared to smaller health centers.
• Healthcare providers attending home deliveries lacked access to all essential resuscitation equipment.

Conclusions:

• Significant deficiencies in essential neonatal resuscitation supplies were observed, particularly for home deliveries.
• The limited availability of resuscitation equipment likely contributes to Nepal's high neonatal mortality rates.
• Urgent implementation of sustainable training programs and equitable equipment distribution is recommended.