Knowledge level of Neonatal Resuscitation and Its Associated factors among Healthcare Professionals at Asella Referral and Teaching Hospital, in Southeast Ethiopia.

Knowledge level of Neonatal Resuscitation and Its Associated factors among Healthcare Professionals at Asella Referral and Teaching Hospital, in Southeast Ethiopia. | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Knowledge level of Neonatal Resuscitation and Its Associated factors among Healthcare Professionals at Asella Referral and Teaching Hospital, in Southeast Ethiopia. Mesfin Wubishet, Tadesse Assefa, Tesfa G/Meskel, Hiwot Zelalem, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4208704/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 29 Sep, 2025 Read the published version in BMC Pediatrics → Version 1 posted 21 You are reading this latest preprint version Abstract Background: Neonatal resuscitation is a critical intervention to save newborns’ life from the state of asphyxia. When performed Effectively by knowledgeable healthcare providers, it can significantly reduce neonatal mortality and morbidity associated with birth asphyxia. However, studies have shown that many health professionals, particularly in low-resource settings like Ethiopia, lack adequate knowledge and skills in neonatal resuscitation. Therefore, this study aimed to assess the knowledge level of health professionals towards neonatal resuscitation and its associated factors. Method: An institutional-based cross-sectional survey was conducted using a structured questionnaire. The survey targeted all health professionals working in the Delivery and Neonatal Intensive Care Units of the hospital. Data were entered and verified using Epi-data version 4.6 and analyzed using SPSS version 26. A binary logistic regression model was used and, a P-value < 0.05 with a 95% confidence interval was used to declare a statistically significant association. Results: The study showed that the majority, 83.2% of health professionals had poor knowledge regarding neonatal resuscitation. Factors significantly associated with a knowledge level of neonatal resuscitation were, being trained in neonatal resuscitation (AOR = 5.39, 95% CI [1.44-20.20]), being male (AOR = 5.80, 95% CI [1.16–29.09]), belonging to a specific profession (AOR = 8.94, 95% CI [1.36-58.68]), receiving supportive supervision (AOR = 3.39, 95% CI [1.01, 11.43]), and achieving a good attitude score (AOR = 5.36, 95% CI [1.52, 18.87]). Conclusion: The overall knowledge level of health professionals regarding Neonatal Resuscitation was poor. Factors significantly associated with participants’ knowledge include receiving neonatal resuscitation training, having supportive supervision, belonging to a specific profession, being male, and achieving a good Attitude score. Therefore, to improve knowledge retention, it is recommended to organize regular and simulation-based neonatal resuscitation training. Furthermore, incorporating basic neonatal resuscitation procedures into undergraduate and postgraduate medical education can enhance students’ knowledge as they serve in the community. Healthcare professionals Knowledge Neonatal resuscitation Southeast Ethiopia Figures Figure 1 Figure 2 Background Neonatal resuscitation is an essential intervention performed on a newborn baby experiencing difficulty in breathing. Resuscitating a neonate is more challenging than resuscitating an adult, older infant, or child. It requires specialized knowledge and skills, particularly during the critical moments immediately after birth, to assist the newborn in breathing. Neonatal resuscitation is a cost-effective intervention that has demonstrated a significant reduction in neonatal mortality due to birth asphyxia by 20% to 30%. Providing effective emergency care during these initial moments is crucial to prevent lifelong consequences (1–3). Globally, around 2.6 million neonates die annually before completing their first month of life. This accounts for 47% of all under-5 deaths and about one-third of these newborns die on their first birth day, and nearly three-quarters do not survive beyond their first week of life. sadly, 99% of these neonatal deaths occur in low- and middle-income countries like sub-Saharan Africa. In SSA, the neonatal mortality rate is 28 deaths per 1000 live births, which is ten times higher than in developed countries. Specifically, Ethiopia is among the five African countries accounting for 50% of neonatal mortality in SSA. As per the Ethiopian Demographic and Health Survey (EDHS) 2019, the neonatal mortality rate in Ethiopia remains high, slightly increasing from 29 to 30 deaths per 1,000 live births in 2019. The causes of these neonatal deaths include neonatal asphyxia, neonatal sepsis, and preterm births. Notably, in resource-limited countries like Ethiopia, neonatal asphyxia contributes to approximately 27% to 30% of neonatal mortality (4–9). Asphyxia, defined by failure to initiate and sustain breathing, significantly contributes to the highest burden of neonatal mortality and morbidity. According to WHO reports from 2020, nearly 700,000 neonatal deaths were attributed to birth asphyxia, accounting for about one-quarter of all neonatal deaths worldwide. Unfortunately, many neonates in developing countries die unnecessarily due to birth-related distress, mainly because health professionals lack the necessary knowledge of how to perform resuscitation (8,10,11). Proper knowledge of newborn resuscitation is crucial in preventing the consequences of perinatal asphyxia, and it is important that the knowledge required to perform neonatal resuscitation should be possessed by all providers of neonatal care. The Existing studies in Ethiopia have highlighted that nurses and midwife possess limited knowledge about neonatal resuscitation, and other essential healthcare professionals(Obs-gyn and pediatric residents) involved in neonatal care were not included (12–18). Despite the importance of neonatal resuscitation (NR) in preventing asphyxia-related deaths, there was limited evidence regarding healthcare professionals’ knowledge of it in the study Area. Therefore, this study targets all health professionals involved in neonatal care and aimed to assess the knowledge of healthcare professionals about neonatal resuscitation and factors affecting it to identify gaps hindering successful reduction in neonatal mortality and disability. In addition, this study was intended to fill the information gap on factors associated with knowledge of neonatal resuscitation and intervene on the identified gaps to improve neonatal survival rates. Finally, it could also help as a prerequisite for the government in collaboration with non-government agencies to successfully integrate child health, including neonatal resuscitation, into developing child health programs. Methods and Materials The study was conducted at Asella Referral and Teaching Hospital, a tertiary hospital located in Asella town, which is 175 km south of the capital city, Addis Ababa. It serves as a referral center for about 3.5 million people in the surrounding districts. The neonatal intensive care unit and delivery units are the busiest wards of the hospital, with the highest admission rate, providing care for newborn babies born in the hospital and referred from other health facilities. These units are run by a team of pediatricians, gynecologists and obstetricians, pediatric residents, GYN-OBS residents, medical interns, unit nurses, and midwives. Study Design and Period An institutional-based cross-sectional survey was conducted on assessment of knowledge on neonatal resuscitation and associated factors among Health Professionals working in the delivery and neonatal intensive care unit of Asella Referral and Teaching Hospital from April 1 to May 30, 2023. Study population/Subjects The study targeted all Health Professionals (Nurses, midwives, Medical Interns, Pediatric and GYN-OBS Residents) working in Delivery and neonatal intensive care unit. The Study subjects were selected purposely because they are directly engaged in neonatal resuscitation and the procedure is mainly performed in the NICU and delivery room. Inclusion and Exclusion criteria All Health Professionals working in the delivery ward and NICU who were available during data collection time and those who gave informed consent were included. Whereas; those individuals with incomplete questionnaires, were inaccessible during data collection time due to illness or annual leave, and who refuses to participate in the study were not included. Sampling size Determination and procedure Since the target populations were relatively small in size, and the sampling frame was complete, the researchers adopted the Census/Survey approach to select the respondents. This means all Study subjects who fit the inclusion criteria were enrolled in the study, which is 231 health professionals working in the delivery ward and NICU. The single population proportion formula was used to estimate the sample size by using the proportion of knowledge level of health professionals taken from the previous study(19), which was 43.2%. After correctional formula was used and addition of 15% for non-response rate, the final sample size become 170, which is less than our Study population (231). So, all study participants were enrolled. Study variables Dependent variables : Knowledge Level towards Neonatal Resuscitation Independent variables: (1). Providers related factors: Sex, Age, Profession, Level of education, Neonatal Resuscitation Training, Work experiences, and Attitude of the Participants towards Neonatal Resuscitation. (2). Institutional related factors: Working unit, Availability of resuscitation equipment, Availability of resuscitation guideline, Supportive supervision, and Work load. Data collection tools A structured English questionnaire s were used to collect data, which was carefully developed by reviewing various sources, including literature(20), WHO guidelines(21), 2015 American Heart Association guidelines(22), Help Babies Breath (HBB) 2nd edition knowledge assessments(2). The tool consists of four sections addressing; 1). Socio-demographic/ provider-related factors, 2). Questions addressing the Attitude or perceptions of participants about neonatal resuscitation, 3). Institutional related factors, 4). thirty-one Multiple choice questions addressing the knowledge of Health Professionals towards neonatal resuscitation. Eight health professionals collected the data under the supervision of the principal investigator. They received three days of training to ensure they understood the study’s objectives, terminology, assessment tools, and ethical considerations. The questionnaires were personally administered to health professionals while they were on duty in labor wards and neonatal intensive care units. Participants had 25-30 minutes to complete the questionnaires, with at least one data collector present to ensure they didn’t refer to textbooks or online resources. After participants finished, we checked the completeness of each questionnaire. The data collection took place over a two-month period, from April 1 to May 30, 2023. Data quality control The data collection tool underwent rigorous validation by subject matter specialists, including neonatologists, pediatricians, nurses, midwives specialized in neonatology care, and researchers with related publications. The Experts assessed each variable’s alignment with the study’s objectives, and the content validity index of the tool was calculated and rated at 0.849. Furthermore, a pre-test was conducted on 5% of study subjects on a similar population in other institutions. Based on the pretest results, adjustments were made by the principal investigator to enhance the tool’s clarity, understandability, and simplicity before actual data collection time. The collected data were reviewed and checked for completeness, clarity, and consistency daily. Measurement of Knowledge Health professionals’ knowledge levels regarding neonatal resuscitation were assessed using a 31-item multiple-choice questionnaire. Correct answers were assigned one point, while incorrect responses received zero points. Participants were subsequently categorized into two groups based on their total scores: those with good knowledge (scoring 80% or higher) and those with poor knowledge (scoring less than 80%). This categorization has been employed in various studies, considering both the overall cumulative mean score and cumulative mean percentage (13,19,20,23–25). Data processing and analysis The data was verified, coded, and entered into Epi Data 4.6 Software and then exported into SPSS version 26 Software for analysis. Descriptive statistics, including frequency, percentage, and mean, were used to describe the analysis results. Additionally, binary logistic regression was employed to explore the association between knowledge and each independent variable. Variables with a significance level (p-value) of ≤ 0.25 in bivariate analysis were considered candidates for multivariable logistic regression to identify associated factors related to good knowledge. The model’s fitness was assessed using Hosmer-Lemeshow statistics and Omnibus tests, with an acceptable fit observed (p-value = 0.65). Finally, odds ratios with 95% confidence intervals were used to measure the direction and strength of statistical associations, with a p-value < 0.05 indicating a statistically significant association with the outcome. Operational Definition Neonatal resuscitation: Intervention after birth to 28 days of the baby to assist in breathing and circulation. Health professionals: In this study refers to midwives, nurses, medical interns and residents working in the delivery ward, NICU, and pediatric ward. Midwives: a health professional who worked in the Obs-gyn wards, and cares for mother and newborns around birth. Nurses : a health professional who worked in the pediatric department or in NICU. Medical interns: Final-year medical students gaining practical experience in major hospital wards, including pediatrics, medicine, obstetrics-gynecology, and surgery. Residents: Physicians undergoing postgraduate study or specialized practice in Obstetrics-Gynecology and pediatric departments. Knowledge: the knowledge level of health professionals was reported as, good knowledge : for those who scored 80% or higher (>=25 correct response from 31 questions) and Poor knowledge: for those who scored below 80% (<25 correct response from 31 questions)(19,24). Attitude: Participants with score of greater than the mean score was considered having good perception and those who scored less than the mean score was considered having poor perception toward neonatal resuscitation(15,16,20). Full equipment for resuscitation: Hospitals with the minimum of the following materials according WHO 2016 Technical Specifications of Neonatal Resuscitation Devices (TSNRD): Radiant warmer, bag with mask, suction machine & catheter, single/multi use suction bulb, stethoscope(26). Work load: Health professionals who serve for more than 5 neonates/24 hours and/or who works for more than 8 hours/24hours according to Ethiopian pediatric society(27). Results Socio-demographic Characteristics of the participants Altogether 231 participants were from the Delivery room, Neonatal intensive care unit, and pediatric ward of the hospital. Out of these, five participants were excluded due to incomplete questionnaires, three participants were on annual leave, and three participants refused to participate. Ultimately, 220 out of the 231 participants were included in the study which gives a response rate of 95.2%. Among the participants, more than half 123 (55.9%) were male. The age range varied from a minimum of 23 years to a maximum of 50 years, with a mean age of 28.05 years (SD = 3.91). Regarding their professions, approximately half (100 or 45.5%) were medical Interns. The remaining participants were: 35 (15.9%) were OBS-GYN residents, 23 (10.5%) were Pediatric residents, 32 (14.5%) were nurses, and 30 (13.6%) were midwives ( Table 1 ). Table 1 : Socio-Demographic Characteristics of Participants Working in NICU and Delivery Room at Asella Referral and Teaching Hospital, South East Ethiopia,2023 (n= 220). Variables Categories Frequency (n) Percent (%) Sex Male 123 55.9 Female 97 44.1 Age of the participants 20-24 18 8.2 25-29 139 63.2 30-34 41 18.6 >=35 22 10.0 Field of study/profession Nurses 32 14.5 Midwives 30 13.6 Medical interns 100 45.5 Pediatric resident 23 10.5 GYN-OBS resident 35 15.9 Level of education Degree 62 28.2 Medical intern 100 45.5 1 st -year resident 20 9.1 2 nd -year resident 17 7.7 3 rd -year resident 15 6.8 4 th -year resident 6 2.7 Note: Nurses include (Neonatal & Comprehensive nurses) Provider-related Characteristics of Participants In terms of the working experience of the respondents, one hundred and nine (49.5%) had less than 1 year of experience. Among all the participants, one hundred and forty-seven (66.8%) of the respondents had never attended any training or seminars related to neonatal resuscitation, while seventy-three (33.2%) of the respondents had attended neonatal resuscitation training. Regarding the attitude of the participants, one hundred and sixteen (52.7%) of them exhibited a poor attitude towards neonatal resuscitation. Additionally, one hundred and seventy-six (80.0%) of the participants provide services for more than five neonates per day. ( Table 2 ). Table 2 : Provider-Related Characteristics of Participants Working in NICU and Delivery Room at Asella Referral and Teaching Hospital, South East Ethiopia,2023 (n= 220). Variables Categories Frequency (n) Percent (%) Total Work experiences 5 yr 34 15.5 Resuscitation Training Yes 73 33.2 NO 147 66.8 Attitude towards neonatal resuscitation Poor 116 52.7 Good 104 47.3 Number of Newborn Served Per/day 0-5 44 20.0 6-10 111 50.5 >10 65 29.5 Institutional-related Characteristics of Participants Among the participants, only twenty (9.1%) of the respondents reported that the hospital had complete resuscitation materials , while the remaining 90.9% indicated that the materials were incomplete. Regarding the availability of neonatal resuscitation guidelines, the majority (91.8%) of the respondents reported that guidelines were not available in their working unit. In terms of workload, one hundred seventy-six (80.0%) of the respondents had workload. Most of the participants, one-hundred and eighty-two (82.7%) had reported that they did not receive supportive supervision. Among the participants, one hundred and sixteen (52.7%) were from the labor ward, while the remaining (47.3%) were from the NICU. Nearly two-thirds of the participants, (63.9%) reported a lack of equipment as the main problem faced during neonatal resuscitation ( Table 3 ). Table 3 : Institutional-Related Characteristics of Participants Working in NICU and Delivery Room at Asella Referral and Teaching Hospital, South East Ethiopia,2023 (n= 220). Variables Categories Frequency (n) Percent (%) Full resuscitation Material Yes 20 9.1 No 200 90.9 Resuscitation Guideline Yes 18 8.2 No 202 91.8 Workload No 42 19.1 Yes 178 80.9 Supportive supervision Yes 38 17.3 No 182 82.7 Current working unit NICU 104 47.3 Labor ward 116 52.7 Problems faced during neonatal resuscitation lack of equipment 140 63.9 Lack of trained assistant 39 17.8 Lack of oxygen 20 9.1 Absence of guideline 20 9.1 Knowledge Levels of the participants towards neonatal resuscitation. This study found that majority, one-hundred and eighty-three (83.2%) of the participants had poor knowledge regarding neonatal resuscitation. of the participants had good knowledge whereas only (16.8%) of the participants had good knowledge ( Figure 1 ). The knowledge scores of the study participants about NR ranged from minimum 32.26% to maximum 90.32% which was observed among medical interns and Pediatrics residents respectively. The poor knowledge score among midwives, medical interns, Nurses, OBGYN residents and pediatrics residents were 28 (93.3%),92 (92%), 27(84.4%),27 (77.1%) and 9(39.1%) respectively ( Figure 2 ). The overall mean knowledge score of the participants were 65.5% (SD=11.6%). The mean knowledge scores of midwives were 60.9%(SD=9.9%), nurses 65.6%(SD=10.7%), medical interns 62.8%(SD=10.6%), pediatrics residents 78.9% (SD=9.4%), and 68.3%(SD=11.1%) for ob-gyn residents ( Table 4 ). Table 4 : Mean Knowledge scores of participants towards neonatal resuscitation in terms of their professions at Asella Referral and Teaching Hospital, South East Ethiopia,2023(n=220). Profession Mean (SD)% Minimum (%) Maximum (%) Std. Deviation (%) Nurses 65.63 38.71 80.65 10.67 Midwives 60.86 45.16 80.65 9.87 Medical Interns 62.81 32.26 87.10 10.62 Pediatric residents 78.96 51.61 90.32 9.37 GYN-OBS residents 68.29 38.71 80.65 11.08 Knowledge scores of the health professionals in different steps of NR In this study, the most frequently answered neonatal resuscitation procedures were the preferred medication for neonatal resuscitation (197, 89.5%), routine care techniques such as drying, removing, and skin-to-skin contact (192, 87.3%), an indication to give volume expander shock (192, 87.3%), the correct position of the neck slightly extended during resuscitation (190, 86.4%), immediately after birth, the baby should be kept on the mother's abdomen (188, 85.5%), the ratio of chest compression to ventilation 3:1 (185, 84.1%), and indications to suction (171, 77.7%). ( Table 5 ). Table 5 : Responses given by health professionals for selected knowledge questions in Asella Teaching and Referral Hospital, Asella, South East Ethiopia, 2023. Questions Response Correct n (%) Incorrect n (%) Slightly extended neck for resuscitation of the new born 190(86.4%) 30(13.6%) Routine care dry, remove and skin to skin 192(87.3%) 28(12.7%) Preferred medication for resuscitation 197(89.5%) 23(10.5%) Immediately after delivery newborn should be placed on the abdomen 188(85.5%) 32(14.5%) Mask covers mouth, nose and tip of chine during resuscitation 40(18.2%) 180(81.8%) Ratio of chest compression to ventilation 3:1 185(84.1%) 35(15.9%) Indication to start volume expander shock 192(87.3%) 28(12.7%) Baby not respond for initial step 85(38.6%) 135(61.4%) Indications to suction 171(77.7%) 49(22.3%) Indication to start chest compression HR<60 Bits per min 143(65.0%) 77(35%) Corrective measure if chest not moving during BMV, reapply the mask. 163(74.1%) 57(25.9%) Ventilation should be commenced within one minute 105(47.7%) 115(52.3%) Chest compression techniques 144(65.8%) 75(34.2%) A measure that can be done for persistent apnea after birth. 132(60.0%) 88(40.0%) The depth of chest compression is 1/3rd of the anterior-posterior diameter. 152(69.1%) 68(30.9%) Assessing the HR of the baby within 30 seconds after giving epinephrine 57(25.9%) 163(74.1%) The correct method to stimulate the baby 105(47.7%) 115(52.3%) Helping to breathe for baby born with meconium 41(18.6%) 179(81.4%) The best source of gas during neonatal resuscitation room air 20(9.1%) 200(90.9%) Factors Associated with knowledge level of participants towards NR Bivariable logistic regression was carried out to identify the factors associated with the knowledge level of the participants. Then the factors with a p-value <0.25 were included in multivariable logistic regression. In multivariable logistic regression, the factors significantly associated with the knowledge level of the participants were; being trained in newborn resuscitation (AOR = 5.39, 95% CI [1.44-20.20]), being male (AOR = 5.80, 95% CI [1.16–29.09]), belonging to a specific profession (AOR = 8.94, 95% CI [1.36-58.68]), receiving supportive supervision (AOR = 3.39, 95% CI [1.01, 11.43]), and achieving a good attitude score (AOR = 5.36, 95% CI [1.52, 18.87]). Participants who had been trained in neonatal resuscitation were nearly five times more knowledgeable than their counterparts. Male participants were about five times more knowledgeable than their female participants. Participants with good attitude score had five times more likely to have good knowledge level about neonatal resuscitation as compared to those with a poor attitude. Participants who got supportive supervision had 3 times more likely to have good knowledge than those with no supportive supervision. Compared to professionals who are nurses, midwives and medical interns, those who are practicing post-graduate resident ship programs scored high on knowledge test (Table 6). Table 6 : Bivariate and multivariate analysis of factors associated with the Knowledge Level of Study Participants towards Neonatal Resuscitation at Asella Referral and Teaching Hospital, South East Ethiopia,2023 (n= 220). Variables Categories Knowledge Level COR [95%CI] AOR [95%CI] (P-Value) Good n(%) Poor n (%) Sex Male 29(23.6) 94(76.4) 3.43 [1.49,7.91] 5.80 [1.16, 29.09] * .033 Female 8(8.2) 89(91.8) 1 1 Age 20-24 yr 2(11.1) 16(88.9) . 18 [ . 03, . 99] .05 [.003, .996] .050 25-29 yr 14(10.1) 125 (89.9) . 16 [ . 06, . 45] .03 [.002, .257] * .002 30-34 yr 12(29.3) 29(70.7) . 598 [ . 20, 1.77] .05 [.004, .565] * .015 >=35 yr 9(40.9) 13(59.1) 1 1 Profession Nurse 5(15.6%) 27(84.4%) . 63 [ . 18, 2.16] 1.04 [.04, 26.92] .982 Midwife 2(6.7) 28(93.3) . 24 [ . 05, 1.24] .02[.001, .532] * .020 Medical Student 8(8.0) 92(92.0) .29[.10, .86] 7.56[.40, 142.89] .177 Pediatric resident 14(60.9) 9(39.1) 5.25 [1.66, 16.59] 8.94 [1.36, 58.68] * .022 GYN-OBS resident 8(22.9) 27(77.1) 1 1 Level of education Degree 7(11.3) 55(88.7) . 13 [ . 02, . 76] Medical intern 8(8.0) 92(92.0) .09 [.02, .50] 1st-year resident 3(15.0) 17(85.0) . 18 [ . 02, 1.33] . 18 [.01, 3.21] .241 2nd -year resident 6(35.3) 11(64.7) . 55 [.08, 3.59] . 12[.01, 2.00] .141 3rd-year resident 10(66.7) 5(33.3) 2.00 [.29, 13.74] . 56 [.04, 8.94] .682 4th-year resident 3(50.0) 3(50.0) 1 1 NR Training Yes 25(34.2) 48(65.8) 5.86 [2.73, 12.57] 5.39 [1.44, 20.20] * .012 No 12(8.2) 135(91.8) 1 1 Attitude towards NR Poor 9(7.8) 107(92.2) 1 1 Good 28(26.9) 76(73.1) 4.38 [1.96, 9.81] 5.36 [1.52, 18.87] * .009 Supportive Supervision Yes 10(26.3) 28(73.7) 2.05 [.89, 4.70] 3.39 [1.01, 11.43] * .048 No 27(14.8) 155(85.2) 1 1 Working experience 5 yr. 9(26.5) 25(73.5) 1 1 Note: * = S tatistically Significant at p -value < 0.05 , 1 = Reference, COR =Crude odds ratio, AOR =Adjusted odds ratio, CI =Confidence interval, NR =neonatal resuscitation. Discussion This study revealed that health professionals’ knowledge of neonatal resuscitation was inadequate. Approximately 83.2% of participants demonstrated insufficient knowledge towards neonatal resuscitation. This poor level knowledge could lead to incorrect practices of the procedure, negatively affecting newborns outcomes. The overall mean knowledge score among participants was 65.5%, falling below the acceptable threshold of 80%. This finding aligns with similar studies conducted in Kenya and Ethiopia(19,24,28). The low knowledge score may be attributed to a lack of consistent and ongoing training and supportive supervision to maintain knowledge of health professionals up to date, as well as limited inclusion of neonatal resuscitation protocols in undergraduate health professional education programs. To address this, continuous training and updates are essential for health professionals to maintain their knowledge and skills in this critical area. This knowledge scores of the participants were higher compared to other studies conducted in Kenya (35.4%)(28), Ghana (38%)(13), study from Ethiopia mean knowledge score of 50%(29), The possible explanations could be due to differences in the qualifications of the participants, the study area, and the extent of training and supportive supervision given for health care providers. There might also be variation in the health care systems and policies across the countries. These factors, partly cited by studies conducted in developing countries, highlight the complexity of maintaining consistent knowledge levels among healthcare professionals(24). In this study, midwives exhibited a suboptimal mean knowledge score (60.9%). This finding was in parallel with a study done in Afghanistan (66% mean score) (23), Ghana( mean score of 61.8%) (13), and South wollo,Ethiopia (66.8% mean score) (30). However, our result surpassed that of a study conducted in North West Ethiopia, where the mean knowledge score was 42.8%. (19). The difference might be quality of training, educational level improvement and exposure of the participants for advanced neonatal resuscitation procedure. The variation could be attributed to differences in training quality, educational advancements, and exposure to advanced neonatal resuscitation procedures. From this study it was found that the mean knowledge score of nurses was poor (65.6%). This finding was comparable with a similar study conducted in India (57%), as well as studies done in Nepal (66%) and South Wollo, Ethiopia (64.5%) (30–32). However, the nurses’ knowledge score was higher than that reported in a study from the Gondar Teaching Hospital, Ethiopia (43.9%)(19), and another study conducted in a selected public hospital in Addis Ababa, Ethiopia (46%) (25). The discrepancy in knowledge levels could be attributed to factors such as differences in attitudes toward neonatal resuscitation, variations in specialized training, and disparities in healthcare facility settings. The Mean knowledge scores of pediatric and Gyni-Obs residents were 78.9% and 68.3% respectively. These result were higher than study done in Gondar Teaching Hospital (42.8%) for pediatric residents, and (42.6%) for Gyni-Obs residents) (19), (74.5%) for pediatric residents from study in public hospitals of Addis Ababa(20), and from the findings observed among Pediatric residents at Khartoum University, Sudan (51.9%) from the result of a study among Pediatric residents in Khartoum University, Sudan (51.9%)(33). But, the result for Gyni-Obs residents were lower than study done in public hospitals of Addis Ababa (77%)(20). The disparity in knowledge levels could be attributed to variations in neonatal resuscitation facilities and the quality of training provided to the residents. However, the knowledge scores of Gyni-Obs residents were comparable to those reported in a study conducted in India (69.1%) (34), and among Iraqi residents (68%) (35). Our study revealed that medical interns had a suboptimal mean knowledge score (62.8%). This low-level score might be due the current teaching curriculum does not provide necessary training for fresh graduates to be competent in neonatal resuscitation. The finding of this study was higher than two other studies conducted in India, where knowledge scores were reported as 54.6% and 48.6% (34,36). The discrepancy might be due to the differences in the study area, and variations in teaching curriculum and policies across different countries. This study shows that, being trained in newborn resuscitation (AOR = 5.39, 95% CI [1.44-20.20]), being male (AOR = 5.80, 95% CI [1.16–29.09]), belonging to a specific profession (AOR = 8.94, 95% CI [1.36-58.68]), receiving supportive supervision (AOR = 3.39, 95% CI [1.01, 11.43]), and achieving a good attitude score (AOR = 5.36, 95% CI [1.52, 18.87]) were significantly associated with knowledge level of health professionals. This was similar to study done in Afghanistan, India, Ghana and Ethiopia revealed training had a forward impact on health professionals’ knowledge(13,23,24,37). In this study, a positive attitude among health professionals was strongly linked to their level of knowledge. This correlation aligns with findings from a Tanzanian study (38). The possible reasons include feelings of non-caring, fear, and anxiety related to their caregiving responsibilities, as well as a perception that their professional role is not central. Encouraging a more positive attitude could potentially enhance health professionals’ knowledge. To achieve this, improving the quality and frequency of training is essential. Additionally, our study revealed a significant relationship between respondents’ sex and their knowledge of neonatal resuscitation, consistent with other studies (16,19). Male participants tend to have better knowledge compared to female participants. This could be probably because women might not actively participate in the resuscitation activities since there are cultural influences where most women are reserved to be involved in different occasions especially in developing countries like Ethiopia, may contribute to this disparity. However, it’s important to note that despite statistical significance, generalizing this finding remains challenging due to our small sample size. In this study, it was found that supportive getting supervision were strongly associated with the knowledge level of health professionals. This finding aligns with research conducted in Afghanistan, where training combined with supportive supervision was significantly associated with higher knowledge score(23). This study also found that there is significant association between respondents aged 25 to 29 years and a good knowledge level of neonatal resuscitation (NR). This finding was against with previous study conducted in Ethiopia. The discrepancy could be attributed to methodological differences, including study participant selection, sample characteristics, and study design. It’s possible that individuals within the specified age group have recently performed and received training on NR, influencing their knowledge levels (19). Limitation of the Study The tool used to assess knowledge on neonatal resuscitation (NR) was self-administered, and health professionals were busy at work while the data were being collected, they might not give accurate information about the knowledge. This issue might negatively affect the study findings. Additionally, the causal association was under caution, as the study design was cross-sectional. Furthermore, the study was conducted at a single teaching government hospital, and the sample size is small, which limits the generalizability of results. Therefore, Readers should take these factors into account when interpreting the study’s findings. Conclusion The study concluded a most of the study participants have inadequate knowledge towards Neonatal Resuscitation. Only 16.8% of the respondents had adequate level of knowledge toward neonatal resuscitation. Receiving training in neonatal resuscitation, having supportive supervision, belonging to a specific profession, being male, and achieving a good Attitude score were Factors significantly associated with participants’ knowledge level. Therefore, to improve knowledge retention, it is recommended to organize regular and simulation-based neonatal resuscitation training. Furthermore, incorporating basic neonatal resuscitation procedures into both undergraduate and postgraduate medical education can enhance students’ knowledge as they serve in the community. Recommendation Ministry of health should strengthen long-term training programs in neonatology and pediatric fields for nurses, midwifes, medical students and residents. Because specialization in these fields can improve towards neonatal resuscitation. Hospital managers and decision makers in collaboration with regional and zonal health bureau should strengthen continuous and regular training on neonatal resuscitation for Health professionals. Hospital managers and decision makers also need to provide periodic supportive supervision and refreshment training for updating knowledge. Different NGOs should contribute to the health care system by delivering training for health professionals and give supportive supervision to provide quality care. Abbreviations ARTH : Asella Referral and Teaching Hospital; AHA: American Heart Association; BMV : Bag and Mask Ventilation; CPAP : Continues Positive Air way pressure; EDHS : Ethiopian Demographic Health Survey; GDA , Global Developmental Alliances; GYN-OBS : Gynecology and Obstetrics; HBB : Helping Baby Breath; HCP : Health Care Professionals; IRRB, Institutional Research Review Board; LMICs :Low and Middle-Income Countries; MDG : Millennium Development Goal; NICU : Neonatal Intensive Care Unit; NR: Neonatal Resuscitation; NRP: Neonatal Resuscitation Program; PPV : Positive Pressure Ventilation; SSA : Sub-Sharan Africa; U5MR : under-five mortality rate. Declarations Acknowledgement The authors are glad to forward their appreciation to Arsi University College Health Science for offering financial support to take on this research project. Our thanks also go to our data collectors, the participants involved in the study, and all our hospital staff members for their collaboration during data collection period. Authors’ contributions MW; contributed to the conception and design of the study, proposal development, data collection, analysis, review and preparation of the manuscript. BS, HZ, TA, and TG; contributed to design and proposal development, assisted during analysis, and a critical review of the document and revision of the manuscript. All authors read and approved the final manuscript for publication and agreed to be accountable for all aspects of the work. Funding Funding for this research was obtained from the ‘Research and Publication Office’ of Arsi University College of Health Sciences for the data collection and stationary materials of the research project. “The institution which provided the fund had no part in study design, data collection, and analysis of the findings, verdict to publish, or preparation of the manuscript.” Availability of data and Sharing Statement All data has been provided within the manuscript. The dataset supporting the conclusions of this article is available from the authors upon reasonable request. Ethical approval and consent to participate Ethical approval was obtained from the Ethical Review Committee (ERC) of Arsi University College of Health Science [Protocol No. A/CHS/RC/73/2023 ]. Formal letter of permission was also obtained from Asella Teaching and Referral hospital administrative office. Informed consent was obtained from each participant after an explanation of what study they will be involved in. The respondents were assured of confidentiality where no unauthorized person has access to the information and names. Consent for publication NOT APPLICABLE for this segment. Declaration of Conflicting Interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. References Pediatric Medicine / Resuscitation / Definition of Neonatal Resuscitation. 2017;(August):2017. Available from: https://en.wikibooks.org/w/index.php Kamath-Rayne BD, Thukral A, Visick MK, Schoen E, Amick E, Deorari A, et al. Helping Babies Breathe, second edition: A model for strengthening educational programs to increase global newborn survival. Glob Heal Sci Pract. 2018;6(3):538–51. Janet S, Carrara VI, Simpson JA, War N, Thin W, Say W, et al. 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Pediatrics. 2013;131(2). Masaba BB, Mmusi-Phetoe RM. Neonatal Survival in Sub-Sahara: A Review of Kenya and South Africa. 2020; Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, et al. Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet. 2016 Dec 17;388(10063):3027–35. Spinozzi P. Death. The Palgrave Handbook of Utopian and Dystopian Literatures. 2022. 699–710 p. Moshiro R, Mdoe P, Perlman JM. A Global View of Neonatal Asphyxia and Resuscitation. Front Pediatr. 2019 Nov 26;7:489. Pammi M, Dempsey EM, Ryan CA, Barrington KJ. Newborn Resuscitation Training Programmes Reduce Early Neonatal Mortality. Neonatology. 2016;110(3):210–24. Alhassan A, Fuseini A-G, Osman W, Basour Adam A. Knowledge and Experience of Neonatal Resuscitation among Midwives in Tamale. Nurs Res Pract. 2019 Jan 2;2019:1–8. Sintayehu Y, Desalew A, Geda B, Shiferaw K, Tiruye G, Mulatu T, et al. 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Available from: http://galaxyjeevandhara.com/index.php/ijss/article/view/674 Gebreegziabher E, Aregawi A, Getinet H. Knowledge and skills of neonatal resuscitation of health professionals at a university teaching hospital of Northwest Ethiopia. World J Emerg Med. 2014;5(3):196. Fatuma A. Knowledge and Practice of Neonatal Resuscitation and Its Associated Factors among Health Professionals Working at Selected Public Hospitals of Addis Ababa. WHO. Recommendations on newborn health: approved by the WHO Guidelines Review Committee. Who. 2017;(May):1–28. Aziz K, Lee HC, Escobedo MB, Hoover A V., Kamath-Rayne BD, Kapadia VS, et al. Part 5: Neonatal Resuscitation: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2020;142(16 2):S524–50. Kim YM, Ansari N, Kols A, Tappis H, Currie S, Zainullah P, et al. Assessing the capacity for newborn resuscitation and factors associated with providers’ knowledge and skills: A cross-sectional study in Afghanistan. BMC Pediatr. 2013 Sep 10;13(1):1–12. Abrha MW, Asresu TT, Araya AA, Weldearegay HG. Healthcare Professionals ’ Knowledge of Neonatal Resuscitation in Ethiopia : Analysis from 2016 National Emergency Obstetric and Newborn Care Survey. 2019;2019:1–8. Bogale M, Hussen H, Tefera M, Busse H. Original article assessment of knowledge of nicu nurses and midwives in neonatal resuscitation in four urban hospitals in addis ababa, ethiopia. 2021;XVI(2). WHO technical specifications of neonatal resuscitation devices. Patterson J, Worku B, Jones D, Clary A, Ramaswamy R, Bose C. Ethiopian Pediatric Society Quality Improvement Initiative: a pragmatic approach to facility-based quality improvement in low-resource settings. BMJ Open Qual. 2021;10(1). Murila F, Obimbo MM, Musoke R. Assessment of knowledge on neonatal resuscitation amongst health care providers in Kenya. Pan Afr Med J. 2012;11:78. Haile-Mariam A, Tesfaye N, Otterness C, Bailey PE. Assessing the health system’s capacity to conduct neonatal resuscitation in Ethiopia. Ethiop Med J. 2012 Jan 1;50(1):43–55. Bizuwork K, Habte T, Birkie M, Woday A. The extent of Knowledge and practice toward neonatal resuscitation among nurses and midwives in public hospitals of South Wollo , northeast Ethiopia : Cross-sectional study. 2019;1–18. Opiyo N, Were F, Govedi F, Fegan G, Wasunna A, English M. Effect of newborn resuscitation training on health worker practices in Pumwani Hospital, Kenya. PLoS One. 2008 Feb 13;3(2). Gauro P, Saha A, Adhikari B. Knowledge and Skill of Newborn Resuscitation among Nurses Working in Maternity Ward. Int J Heal Sci Res. 2018;8(2):149–54. TREVISANUTO D, IBRAHIM SA, DOGLIONI N, SALVADORI S, FERRARESE P, ZANARDO V. Neonatal resuscitation courses for pediatric residents: comparison between Khartoum (Sudan) and Padova (Italy). Pediatr Anesth. 2007;17(1):28–31. Taksande AM. NEONATAL RESUSCITATION TRAINING PROGRAMME , ITS EFFICIENCY AT RURAL HOSPITAL. 2012;6–9. Jabir MM, Doglioni N, Fadhil T, Zanardo V, Trevisanuto D. Knowledge and practical performance gained by Iraqi residents after participation to a neonatal resuscitation program course. Acta Paediatr Int J Paediatr. 2009;98(8):1265–8. Gautam P, Sharma N. Assessing competency in neonatal resuscitation among medical students , interns and postgraduate students : a study from a tertiary care hospital in North India. 2022;10(9):1958–62. Bansal SC, Nimbalkar AS, Patel D V., Sethi AR, Phatak AG, Nimbalkar SM. Current Neonatal Resuscitation Practices among Paediatricians in Gujarat, India. Int J Pediatr. 2014;2014:1–7. Moshiro R, Ersdal HL, Mdoe P, Kidanto HL, Mbekenga C. Factors affecting effective ventilation during newborn resuscitation: a qualitative study among midwives in rural Tanzania. Glob Health Action. 2018 Jan 1;11(1). Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4208704","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":288914360,"identity":"47b14bef-3e2b-47f7-99c6-efd66ea8f5b4","order_by":0,"name":"Mesfin Wubishet","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+ElEQVRIiWNgGAWjYLACxgYGBn5mxsYHH4AcNnZitUi2Nx82nAHSwkysFoMzx9KkeUA8Qlp029ufSfPuOGzXcCPHTNrm1zZ5PmYGxg8fc3BrMTtzxkya98zh5MYZOcbWuX23DduYGZglZ27Do+VGDttt3rbbycwSOYa3c3tuMwK1sDHz4tNy//kzsBY2iRwDacue2/aEtdxgMANpsePhOZYkzfDjdiJhLWdyzH/OPfM/QYIdGMi9DbeT25gZm/H75fjxxwZvd6TZ2x8GRuWPP7dt57c3H/zwEY8WGEhsAJGMbWCygbB6ILCHUH+IUjwKRsEoGAUjDAAAklVXLYUrFEAAAAAASUVORK5CYII=","orcid":"","institution":"Arsi University College of Health Sciences","correspondingAuthor":true,"prefix":"","firstName":"Mesfin","middleName":"","lastName":"Wubishet","suffix":""},{"id":288914361,"identity":"c77deadf-4778-490c-b254-314eafb81b3f","order_by":1,"name":"Tadesse Assefa","email":"","orcid":"","institution":"Arsi University College of Health Sciences","correspondingAuthor":false,"prefix":"","firstName":"Tadesse","middleName":"","lastName":"Assefa","suffix":""},{"id":288914362,"identity":"52645958-fedc-4136-9842-b1c6fc343496","order_by":2,"name":"Tesfa G/Meskel","email":"","orcid":"","institution":"Arsi University College of Health Sciences","correspondingAuthor":false,"prefix":"","firstName":"Tesfa","middleName":"","lastName":"G/Meskel","suffix":""},{"id":288914363,"identity":"9f5d38c2-62ff-445d-b6ce-6ab200f838e1","order_by":3,"name":"Hiwot Zelalem","email":"","orcid":"","institution":"Arsi University College of Health Sciences","correspondingAuthor":false,"prefix":"","firstName":"Hiwot","middleName":"","lastName":"Zelalem","suffix":""},{"id":288914364,"identity":"83e2de92-8614-4e03-ac4c-b0b75e3713d2","order_by":4,"name":"Betre Shimelis","email":"","orcid":"","institution":"Haramaya University College of Health and Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Betre","middleName":"","lastName":"Shimelis","suffix":""}],"badges":[],"createdAt":"2024-04-02 20:44:23","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4208704/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4208704/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12887-025-06061-1","type":"published","date":"2025-09-29T15:57:03+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":54445425,"identity":"2d1a0308-bd12-4b71-afb3-26b9c598023a","added_by":"auto","created_at":"2024-04-10 16:16:20","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":37465,"visible":true,"origin":"","legend":"\u003cp\u003eKnowledge level of Health professionals towards neonatal resuscitation at Asella Referral and Teaching Hospital, South East Ethiopia, 2023(n=220).\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4208704/v1/dbd4bb58635ecd73f4fa3b2a.png"},{"id":54445424,"identity":"4f4f7583-9ba5-4f32-8156-ffd3080c90a8","added_by":"auto","created_at":"2024-04-10 16:16:19","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":68148,"visible":true,"origin":"","legend":"\u003cp\u003eOverall Knowledge Scores of participants towards neonatal resuscitation in terms of profession at Asella Referral and Teaching Hospital, South East Ethiopia,2023(n=220).\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4208704/v1/662776edca3a3865c0ad30e1.png"},{"id":92883631,"identity":"5433b468-3822-45f3-a76c-74dc14afceaf","added_by":"auto","created_at":"2025-10-06 16:06:34","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1569384,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4208704/v1/43925ab4-d88e-4e43-98f2-01f46307cc6e.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Knowledge level of Neonatal Resuscitation and Its Associated factors among Healthcare Professionals at Asella Referral and Teaching Hospital, in Southeast Ethiopia.","fulltext":[{"header":"Background","content":"\u003cp\u003eNeonatal resuscitation is an essential intervention performed on a newborn baby experiencing difficulty in breathing. Resuscitating a neonate is more challenging than resuscitating an adult, older infant, or child. It requires specialized knowledge and skills, particularly during the critical moments immediately after birth, to assist the newborn in breathing. Neonatal resuscitation is a cost-effective intervention that has demonstrated a significant reduction in neonatal mortality due to birth asphyxia by 20% to 30%. Providing effective emergency care during these initial moments is crucial to prevent lifelong consequences\u0026nbsp;(1\u0026ndash;3). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGlobally, around 2.6 million neonates die annually before completing their first month of life. This accounts for\u0026nbsp;47% of all under-5 deaths and about one-third of these newborns die\u0026nbsp;on their first birth day, and nearly three-quarters do not survive beyond their first week of life. sadly, 99% of these neonatal deaths occur in low- and middle-income countries like sub-Saharan Africa. In SSA, the neonatal mortality rate is 28 deaths per 1000 live births, which is ten times higher than in developed countries. Specifically, Ethiopia is among the five African countries accounting for 50% of neonatal mortality in SSA. As per the Ethiopian Demographic and Health Survey (EDHS) 2019, the neonatal mortality rate in Ethiopia remains high, slightly increasing from 29 to 30 deaths per 1,000 live births in 2019. The causes of these neonatal deaths include neonatal asphyxia, neonatal sepsis, and preterm births. Notably, in resource-limited countries like Ethiopia, neonatal asphyxia contributes to approximately 27% to 30% of neonatal mortality\u0026nbsp;(4\u0026ndash;9).\u003c/p\u003e\n\u003cp\u003eAsphyxia, defined by failure to initiate and sustain breathing, significantly contributes to the highest burden of neonatal mortality and morbidity. According to WHO reports from 2020, nearly 700,000 neonatal deaths were attributed to birth asphyxia, accounting for about one-quarter of all neonatal deaths\u0026nbsp;worldwide.\u0026nbsp;Unfortunately, many neonates in developing countries die unnecessarily due to birth-related distress, mainly because health professionals lack the necessary knowledge of how to perform resuscitation\u0026nbsp;(8,10,11).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eProper knowledge of newborn resuscitation is crucial in preventing the consequences of perinatal asphyxia, and\u0026nbsp;it is important that the knowledge required to perform neonatal resuscitation should be possessed by all providers of neonatal care.\u0026nbsp;The\u0026nbsp;Existing studies in Ethiopia have highlighted that nurses and midwife possess limited knowledge about neonatal resuscitation, and other essential healthcare professionals(Obs-gyn and pediatric residents) involved in neonatal care were not included\u0026nbsp;(12\u0026ndash;18).\u0026nbsp;Despite the importance of neonatal\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eresuscitation (NR) in preventing asphyxia-related deaths, there was \u003cstrong\u003elimited evidence\u003c/strong\u003e regarding healthcare professionals\u0026rsquo; knowledge\u0026nbsp;of it in the study Area.\u0026nbsp;Therefore, this study targets \u003cstrong\u003eall health professionals\u003c/strong\u003e involved in neonatal care and aimed to assess the knowledge of healthcare professionals about neonatal resuscitation and factors affecting it to identify gaps hindering successful reduction in neonatal mortality and disability. In addition, this study was intended to fill the information gap on factors associated with knowledge of neonatal resuscitation and intervene on the identified gaps to improve neonatal survival rates. Finally, it could also help as a prerequisite for the government in collaboration with non-government agencies to successfully integrate child health, including neonatal resuscitation, into developing child health programs.\u003c/p\u003e"},{"header":" Methods and Materials","content":"\u003cp\u003eThe study was conducted\u0026nbsp;at\u0026nbsp;Asella Referral and Teaching Hospital, a tertiary hospital located in Asella town,\u0026nbsp;which is 175 km south of the capital city, Addis Ababa. It serves as a referral center for about 3.5 million people in the surrounding districts. The neonatal intensive care unit and delivery units are the busiest wards of the hospital, with the highest admission rate, providing care for newborn babies born in the hospital and referred from other health facilities. These units are run by a team of pediatricians, gynecologists and obstetricians, pediatric residents, GYN-OBS residents, medical interns, unit nurses, and midwives.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Study Design and Period\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAn institutional-based cross-sectional survey was conducted on assessment of knowledge on neonatal resuscitation and associated factors among Health Professionals working in the delivery and neonatal intensive care unit of Asella Referral and Teaching Hospital from April 1 to May 30, 2023. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Study population/Subjects\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The study targeted all Health Professionals (Nurses, midwives, Medical Interns, Pediatric and GYN-OBS Residents) working in Delivery and neonatal intensive care unit. The Study subjects were selected purposely because they are directly engaged in neonatal resuscitation and the procedure is mainly performed in the NICU and delivery room.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion and Exclusion criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll Health Professionals working in the delivery ward and NICU who were available during data collection time and those who gave informed consent were included. Whereas; those individuals with incomplete questionnaires, were inaccessible during data collection time due to illness or annual leave, and who refuses to participate in the study were not included.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSampling size\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Determination\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;and procedure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSince the target populations were relatively small in size, and the sampling frame was complete, the researchers adopted the Census/Survey approach to select the respondents. This means all Study subjects who fit the inclusion criteria were enrolled in the study, which is 231 health professionals\u0026nbsp;working\u0026nbsp;in the delivery ward and NICU. The single population proportion formula was\u0026nbsp;used to estimate the sample size by using the proportion of knowledge level of\u0026nbsp;health professionals\u0026nbsp;taken from the previous study(19), which was 43.2%. After correctional formula was used and addition of 15% for non-response rate, the final sample size become 170, which is less than our\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eStudy population (231). So, all study participants were enrolled.\u003c/p\u003e\n\u003ch2\u003e\u0026nbsp;Study variables\u003c/h2\u003e\n\u003cp\u003e\u003cstrong\u003eDependent variables\u003c/strong\u003e: \u0026nbsp;Knowledge Level towards Neonatal Resuscitation\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIndependent variables:\u0026nbsp;\u003c/strong\u003e(1). Providers related factors: Sex, Age, Profession,\u0026nbsp;Level of education,\u0026nbsp;Neonatal Resuscitation Training,\u0026nbsp;Work experiences, and Attitude of the Participants towards Neonatal Resuscitation. (2). Institutional related factors: Working unit, Availability of resuscitation equipment, Availability of resuscitation guideline, Supportive supervision, and Work load.\u003c/p\u003e\n\u003ch2\u003eData collection tools\u003c/h2\u003e\n\u003cp\u003e\u0026nbsp;A \u003cstrong\u003estructured English questionnaire\u003c/strong\u003e\u003cstrong\u003es\u003c/strong\u003e were used to collect data, which was carefully developed by reviewing various sources, including literature(20), WHO guidelines(21), 2015 American Heart Association guidelines(22), Help Babies Breath (HBB) 2nd edition knowledge assessments(2). The tool consists of four sections addressing; 1). Socio-demographic/ provider-related factors, 2). Questions addressing the Attitude or perceptions of participants about neonatal resuscitation, 3). Institutional related factors, 4). thirty-one Multiple choice questions addressing the knowledge of Health Professionals towards neonatal resuscitation.\u003c/p\u003e\n\u003cp\u003eEight health professionals collected the data under the supervision of the principal investigator. They received three days of training to ensure they understood the study\u0026rsquo;s objectives, terminology, assessment tools, and ethical considerations. The questionnaires were personally administered to health professionals while they were on duty in labor wards and neonatal intensive care units. Participants had\u0026nbsp;25-30 minutes\u0026nbsp;to complete the questionnaires, with at least one data collector present to ensure they didn\u0026rsquo;t refer to textbooks or online resources. After participants finished, we checked the completeness of each questionnaire. The data collection took place over a\u0026nbsp;two-month period, from April 1 to May 30, 2023.\u003c/p\u003e\n\u003ch2\u003eData quality control\u003c/h2\u003e\n\u003cp\u003eThe data collection tool underwent rigorous validation by subject matter specialists, including neonatologists, pediatricians, nurses, midwives specialized in neonatology care, and researchers with related publications. The Experts assessed each variable\u0026rsquo;s alignment with the study\u0026rsquo;s objectives, and the content validity index of the tool was calculated and rated at 0.849. Furthermore, a pre-test was conducted on 5% of study subjects on a similar population in other institutions. Based on the pretest results, adjustments were made by the principal investigator to enhance the tool\u0026rsquo;s clarity, understandability, and simplicity before actual data collection time. The collected data were reviewed and checked for completeness, clarity, and consistency daily.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eMeasurement of Knowledge\u003c/h2\u003e\n\u003cp\u003eHealth professionals\u0026rsquo; knowledge levels regarding neonatal resuscitation were assessed using a 31-item multiple-choice questionnaire. Correct answers were assigned one point, while incorrect responses received zero points. Participants were subsequently categorized into two groups based on their total scores: those with good knowledge (scoring 80% or higher) and those with poor knowledge (scoring less than 80%). This categorization has been employed in various studies, considering both the overall cumulative mean score and cumulative mean percentage (13,19,20,23\u0026ndash;25).\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003e\u0026nbsp;Data processing and analysis \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eThe data was verified, coded, and entered into Epi Data 4.6 Software and then exported into SPSS version 26 Software for analysis. Descriptive statistics, including frequency, percentage, and mean, were used to describe the analysis results. Additionally, binary logistic regression was employed to explore the association between knowledge and each independent variable. Variables with a significance level (p-value) of \u0026le; 0.25 in bivariate analysis were considered candidates for multivariable logistic regression to identify associated factors related to good knowledge. The model\u0026rsquo;s fitness was assessed using Hosmer-Lemeshow statistics and Omnibus tests, with an acceptable fit observed (p-value = 0.65). Finally, odds ratios with 95% confidence intervals were used to measure the direction and strength of statistical associations, with a p-value \u0026lt; 0.05 indicating a statistically significant association with the outcome. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eOperational Definition\u003c/h2\u003e\n\u003cp\u003e\u003cstrong\u003eNeonatal resuscitation:\u003c/strong\u003e Intervention after birth to 28 days of the baby to assist in breathing and circulation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHealth professionals:\u003c/strong\u003e In this study refers to midwives, nurses, medical interns and residents working in the delivery ward, NICU, and pediatric ward.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMidwives:\u003c/strong\u003e\u0026nbsp; a health professional who worked in the Obs-gyn wards, and cares for mother and newborns around birth.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNurses\u003c/strong\u003e: a health professional who worked in the pediatric department or in NICU.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMedical interns:\u003c/strong\u003e Final-year medical students gaining practical experience in major hospital wards, including pediatrics, medicine, obstetrics-gynecology, and surgery.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResidents:\u003c/strong\u003e Physicians undergoing postgraduate study or specialized practice in Obstetrics-Gynecology and pediatric departments.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eKnowledge:\u003c/strong\u003e the knowledge level of health professionals was reported as, \u003cem\u003egood knowledge\u003c/em\u003e\u003cstrong\u003e:\u003c/strong\u003e for those who scored \u003cstrong\u003e80% or\u0026nbsp;\u003c/strong\u003ehigher (\u0026gt;=25 correct response from 31 questions) and \u003cem\u003ePoor knowledge:\u003c/em\u003e\u0026nbsp; \u0026nbsp;for those who scored \u003cstrong\u003ebelow 80%\u003c/strong\u003e (\u0026lt;25 correct response from 31 questions)(19,24).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAttitude:\u003c/strong\u003e Participants with score of greater than the mean score was considered having good perception and those who scored less than the mean score was considered having poor perception toward neonatal resuscitation(15,16,20).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFull equipment for resuscitation:\u003c/strong\u003e Hospitals with the minimum of the following materials according WHO 2016 Technical Specifications of Neonatal Resuscitation Devices (TSNRD): Radiant warmer, bag with mask, suction machine \u0026amp; catheter, single/multi use suction bulb, stethoscope(26).\u003cbr\u003e\u003cstrong\u003eWork load:\u003c/strong\u003e\u003cu\u003e\u0026nbsp;\u003c/u\u003eHealth professionals who serve for more than 5 neonates/24 hours and/or who works for more than 8 hours/24hours according to Ethiopian pediatric society(27).\u003c/p\u003e"},{"header":"Results","content":"\u003ch2\u003eSocio-demographic Characteristics\u0026nbsp;of the participants\u003c/h2\u003e\n\u003cp\u003eAltogether 231 participants were from the Delivery room, Neonatal intensive care unit, and pediatric ward of the hospital. Out of these, five participants were excluded due to incomplete questionnaires, three participants were on annual leave, and three participants refused to participate. Ultimately, 220 out of the 231 participants were included in the study which gives a response rate of 95.2%. \u0026nbsp;Among the participants, more than half 123 (55.9%) were male. The age range varied from a minimum of 23 years to a maximum of 50 years, with a mean age of 28.05 years (SD = 3.91). Regarding their professions, approximately half (100 or 45.5%) were medical Interns. The remaining participants were: 35 (15.9%) were OBS-GYN residents, 23 (10.5%) were Pediatric residents, 32 (14.5%) were nurses, and 30 (13.6%) were midwives (\u003cstrong\u003eTable 1\u003c/strong\u003e).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003e\u0026nbsp;Table\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e Socio-Demographic Characteristics of Participants Working in NICU and Delivery Room at Asella Referral and Teaching Hospital, South East Ethiopia,2023 (n= 220).\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"111%\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.6530612244898%\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.571428571428573%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.367346938775512%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.6530612244898%\" rowspan=\"2\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.571428571428573%\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.367346938775512%\"\u003e\n \u003cp\u003e123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\"\u003e\n \u003cp\u003e55.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.42424242424242%\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.303030303030305%\"\u003e\n \u003cp\u003e44.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.6530612244898%\" rowspan=\"4\"\u003e\n \u003cp\u003eAge of the participants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.571428571428573%\"\u003e\n \u003cp\u003e20-24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.367346938775512%\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\"\u003e\n \u003cp\u003e8.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.42424242424242%\"\u003e\n \u003cp\u003e25-29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\"\u003e\n \u003cp\u003e139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.303030303030305%\"\u003e\n \u003cp\u003e63.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.42424242424242%\"\u003e\n \u003cp\u003e30-34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.303030303030305%\"\u003e\n \u003cp\u003e18.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.42424242424242%\"\u003e\n \u003cp\u003e\u0026gt;=35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.303030303030305%\"\u003e\n \u003cp\u003e10.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.6530612244898%\" rowspan=\"5\"\u003e\n \u003cp\u003eField of study/profession\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.571428571428573%\"\u003e\n \u003cp\u003eNurses\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.367346938775512%\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\"\u003e\n \u003cp\u003e14.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.42424242424242%\"\u003e\n \u003cp\u003eMidwives\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.303030303030305%\"\u003e\n \u003cp\u003e13.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.42424242424242%\"\u003e\n \u003cp\u003eMedical interns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.303030303030305%\"\u003e\n \u003cp\u003e45.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.42424242424242%\"\u003e\n \u003cp\u003ePediatric resident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.303030303030305%\"\u003e\n \u003cp\u003e10.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.42424242424242%\"\u003e\n \u003cp\u003eGYN-OBS resident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.303030303030305%\"\u003e\n \u003cp\u003e15.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.6530612244898%\" rowspan=\"6\"\u003e\n \u003cp\u003eLevel of education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.571428571428573%\"\u003e\n \u003cp\u003eDegree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.367346938775512%\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\"\u003e\n \u003cp\u003e28.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.42424242424242%\"\u003e\n \u003cp\u003eMedical intern\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.303030303030305%\"\u003e\n \u003cp\u003e45.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.42424242424242%\"\u003e\n \u003cp\u003e1\u003csup\u003est\u003c/sup\u003e-year resident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.303030303030305%\"\u003e\n \u003cp\u003e9.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.42424242424242%\"\u003e\n \u003cp\u003e2\u003csup\u003end\u003c/sup\u003e-year resident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.303030303030305%\"\u003e\n \u003cp\u003e7.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.42424242424242%\"\u003e\n \u003cp\u003e3\u003csup\u003erd\u003c/sup\u003e-year resident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.303030303030305%\"\u003e\n \u003cp\u003e6.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.42424242424242%\"\u003e\n \u003cp\u003e4\u003csup\u003eth\u003c/sup\u003e-year resident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.272727272727273%\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.303030303030305%\"\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eNote:\u003c/em\u003e\u003c/strong\u003e Nurses include (Neonatal \u0026amp; Comprehensive nurses)\u003c/p\u003e\n\u003ch2\u003e\u0026nbsp;Provider-related Characteristics of Participants\u003c/h2\u003e\n\u003cp\u003eIn terms of the working experience of the respondents, one hundred and nine (49.5%) had less than 1 year of experience. Among all the participants, one hundred and forty-seven (66.8%) of the respondents had never attended any training or seminars related to neonatal resuscitation, while seventy-three (33.2%) of the respondents had attended neonatal resuscitation training. Regarding the attitude of the participants, one hundred and sixteen (52.7%) of them exhibited a poor attitude towards neonatal resuscitation. Additionally,\u0026nbsp;one hundred and seventy-six (80.0%)\u0026nbsp;of the participants provide services for more than five neonates per day.\u0026nbsp;(\u003cstrong\u003eTable \u003cem\u003e2\u003c/em\u003e\u003c/strong\u003e).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e\u0026nbsp; Provider-Related Characteristics of Participants Working in NICU and Delivery Room at Asella Referral and Teaching Hospital, South East Ethiopia,2023 (n= 220).\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"107%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.22222222222222%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.22222222222222%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.22222222222222%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ePercent (%)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" rowspan=\"3\"\u003e\n \u003cp\u003eTotal Work experiences\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.22222222222222%\"\u003e\n \u003cp\u003e\u0026lt;1 yr\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.22222222222222%\" valign=\"top\"\u003e\n \u003cp\u003e109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.22222222222222%\" valign=\"top\"\u003e\n \u003cp\u003e49.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e1-5 yr\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e35.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026gt; 5 yr\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e15.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u0026nbsp; Resuscitation Training\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.22222222222222%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.22222222222222%\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.22222222222222%\"\u003e\n \u003cp\u003e33.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eNO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e66.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u0026nbsp; Attitude towards neonatal\u003cbr\u003e\u0026nbsp; \u0026nbsp;resuscitation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.22222222222222%\"\u003e\n \u003cp\u003ePoor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.22222222222222%\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.22222222222222%\"\u003e\n \u003cp\u003e52.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e47.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" rowspan=\"3\"\u003e\n \u003cp\u003eNumber of Newborn\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;Served Per/day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.22222222222222%\"\u003e\n \u003cp\u003e0-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.22222222222222%\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.22222222222222%\"\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e6-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e50.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e\u0026gt;10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\"\u003e\n \u003cp\u003e29.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003ch2\u003eInstitutional-related Characteristics of Participants\u003c/h2\u003e\n\u003cp\u003eAmong the participants, only \u003cstrong\u003etwenty (9.1%)\u003c/strong\u003e of the respondents reported that the hospital had \u003cstrong\u003ecomplete resuscitation materials\u003c/strong\u003e, while the \u003cstrong\u003eremaining 90.9%\u003c/strong\u003e indicated that the materials were \u003cstrong\u003eincomplete.\u003c/strong\u003e Regarding the availability of neonatal resuscitation guidelines, the majority (91.8%) of the respondents reported that guidelines were not available in their working unit. In terms of workload, one hundred seventy-six (80.0%) of the respondents had workload. Most of the participants, one-hundred and eighty-two (82.7%) had reported that they did not receive supportive supervision. Among the participants, one hundred and sixteen (52.7%) were from the labor ward, while the remaining (47.3%) were from the NICU. Nearly two-thirds of the participants, (63.9%) reported a lack of equipment as the main problem faced during neonatal resuscitation (\u003cstrong\u003eTable \u003cem\u003e3\u003c/em\u003e\u003c/strong\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e Institutional-Related Characteristics of Participants Working in NICU and Delivery Room at Asella Referral and Teaching Hospital, South East Ethiopia,2023 (n= 220).\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"108%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.31313131313131%\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.303030303030305%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.2020202020202%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.181818181818183%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.31313131313131%\" rowspan=\"2\"\u003e\n \u003cp\u003eFull resuscitation Material\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.303030303030305%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.2020202020202%\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.181818181818183%\"\u003e\n \u003cp\u003e9.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.11764705882353%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.41176470588235%\"\u003e\n \u003cp\u003e200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.470588235294116%\"\u003e\n \u003cp\u003e90.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.31313131313131%\" rowspan=\"2\"\u003e\n \u003cp\u003eResuscitation Guideline\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.303030303030305%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.2020202020202%\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.181818181818183%\"\u003e\n \u003cp\u003e8.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.11764705882353%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.41176470588235%\"\u003e\n \u003cp\u003e202\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.470588235294116%\"\u003e\n \u003cp\u003e91.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.31313131313131%\" rowspan=\"2\"\u003e\n \u003cp\u003eWorkload\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.303030303030305%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.2020202020202%\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.181818181818183%\"\u003e\n \u003cp\u003e19.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.11764705882353%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.41176470588235%\"\u003e\n \u003cp\u003e178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.470588235294116%\"\u003e\n \u003cp\u003e80.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.31313131313131%\" rowspan=\"2\"\u003e\n \u003cp\u003eSupportive supervision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.303030303030305%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.2020202020202%\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.181818181818183%\"\u003e\n \u003cp\u003e17.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.11764705882353%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.41176470588235%\"\u003e\n \u003cp\u003e182\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.470588235294116%\"\u003e\n \u003cp\u003e82.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.31313131313131%\" rowspan=\"2\"\u003e\n \u003cp\u003eCurrent working unit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.303030303030305%\"\u003e\n \u003cp\u003eNICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.2020202020202%\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.181818181818183%\"\u003e\n \u003cp\u003e47.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.11764705882353%\"\u003e\n \u003cp\u003eLabor ward\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.41176470588235%\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.470588235294116%\"\u003e\n \u003cp\u003e52.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.31313131313131%\" rowspan=\"4\"\u003e\n \u003cp\u003eProblems faced during neonatal resuscitation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.303030303030305%\"\u003e\n \u003cp\u003elack of equipment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.2020202020202%\"\u003e\n \u003cp\u003e140\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.181818181818183%\"\u003e\n \u003cp\u003e63.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.11764705882353%\"\u003e\n \u003cp\u003eLack of trained assistant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.41176470588235%\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.470588235294116%\"\u003e\n \u003cp\u003e17.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.11764705882353%\"\u003e\n \u003cp\u003eLack of oxygen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.41176470588235%\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.470588235294116%\"\u003e\n \u003cp\u003e9.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.11764705882353%\"\u003e\n \u003cp\u003eAbsence of guideline\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.41176470588235%\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.470588235294116%\"\u003e\n \u003cp\u003e9.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003ch2\u003eKnowledge Levels of the participants towards neonatal resuscitation.\u003c/h2\u003e\n\u003cp\u003eThis study found that majority, one-hundred and eighty-three (83.2%) of the participants had poor knowledge regarding neonatal resuscitation.\u0026nbsp;of the participants had good knowledge whereas only (16.8%) of the participants had good knowledge\u0026nbsp;(\u003cstrong\u003e\u003cem\u003eFigure 1\u003c/em\u003e\u003c/strong\u003e). The knowledge scores of the study participants about NR ranged from\u0026nbsp;minimum\u0026nbsp;32.26% to\u0026nbsp;maximum\u0026nbsp;90.32% which\u0026nbsp;was observed among medical interns and Pediatrics residents respectively.\u0026nbsp;The poor knowledge score among midwives, medical interns,\u0026nbsp;Nurses, OBGYN residents and pediatrics residents were\u0026nbsp;28 (93.3%),92 (92%),\u0026nbsp;27(84.4%),27 (77.1%) and 9(39.1%) respectively (\u003cstrong\u003eFigure 2\u003c/strong\u003e).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe overall mean knowledge score of the participants were\u0026nbsp;65.5% (SD=11.6%).\u0026nbsp;The mean knowledge scores of midwives were 60.9%(SD=9.9%), nurses 65.6%(SD=10.7%), medical interns 62.8%(SD=10.6%), pediatrics residents 78.9% (SD=9.4%), and 68.3%(SD=11.1%) for ob-gyn residents (\u003cstrong\u003eTable 4\u003c/strong\u003e). \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e4\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e Mean Knowledge scores of participants towards neonatal resuscitation in terms of their professions at Asella Referral and Teaching Hospital, South East Ethiopia,2023(n=220).\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.804123711340207%\"\u003e\n \u003cp\u003e\u003cstrong\u003eProfession\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMinimum (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMaximum (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e\u003cstrong\u003eStd. Deviation (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.804123711340207%\"\u003e\n \u003cp\u003eNurses\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\" valign=\"top\"\u003e\n \u003cp\u003e65.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\"\u003e\n \u003cp\u003e38.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\"\u003e\n \u003cp\u003e80.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\" valign=\"top\"\u003e\n \u003cp\u003e10.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.804123711340207%\"\u003e\n \u003cp\u003eMidwives\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\" valign=\"top\"\u003e\n \u003cp\u003e60.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\"\u003e\n \u003cp\u003e45.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\"\u003e\n \u003cp\u003e80.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\" valign=\"top\"\u003e\n \u003cp\u003e9.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.804123711340207%\"\u003e\n \u003cp\u003eMedical Interns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\" valign=\"top\"\u003e\n \u003cp\u003e62.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\"\u003e\n \u003cp\u003e32.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\"\u003e\n \u003cp\u003e87.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\" valign=\"top\"\u003e\n \u003cp\u003e10.62\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.804123711340207%\"\u003e\n \u003cp\u003ePediatric residents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\" valign=\"top\"\u003e\n \u003cp\u003e78.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\"\u003e\n \u003cp\u003e51.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\"\u003e\n \u003cp\u003e90.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\" valign=\"top\"\u003e\n \u003cp\u003e9.37\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.804123711340207%\"\u003e\n \u003cp\u003eGYN-OBS residents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\" valign=\"top\"\u003e\n \u003cp\u003e68.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\"\u003e\n \u003cp\u003e38.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" valign=\"top\"\u003e\n \u003cp\u003e80.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\" valign=\"top\"\u003e\n \u003cp\u003e11.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n\u003c/table\u003e\n\u003ch2\u003eKnowledge scores of the health professionals in different steps of NR\u003c/h2\u003e\n\u003cp\u003eIn this study, the most frequently answered neonatal resuscitation procedures were the preferred medication for neonatal resuscitation (197, 89.5%), routine care techniques such as drying, removing, and skin-to-skin contact (192, 87.3%), an indication to give volume expander shock (192, 87.3%), the correct position of the neck slightly extended during resuscitation (190, 86.4%), immediately after birth, the baby should be kept on the mother\u0026apos;s abdomen (188, 85.5%), the ratio of chest compression to ventilation 3:1 (185, 84.1%), and indications to suction (171, 77.7%). (\u003cstrong\u003eTable \u003cem\u003e5\u003c/em\u003e\u003c/strong\u003e).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e5\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e Responses given by health professionals for selected knowledge questions in Asella Teaching and Referral Hospital, Asella, South East Ethiopia, 2023.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"107%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"64.64646464646465%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eQuestions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"35.35353535353536%\" colspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eResponse\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.714285714285715%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCorrect n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"54.285714285714285%\"\u003e\n \u003cp\u003e\u003cstrong\u003eIncorrect n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"64.64646464646465%\"\u003e\n \u003cp\u003eSlightly extended neck for resuscitation of the new born\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.161616161616163%\"\u003e\n \u003cp\u003e190(86.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\"\u003e\n \u003cp\u003e30(13.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"64.64646464646465%\"\u003e\n \u003cp\u003eRoutine\u0026nbsp;care\u0026nbsp;dry,\u0026nbsp;remove\u0026nbsp;and\u0026nbsp;skin\u0026nbsp;to\u0026nbsp;skin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.161616161616163%\"\u003e\n \u003cp\u003e192(87.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\"\u003e\n \u003cp\u003e28(12.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"64.64646464646465%\"\u003e\n \u003cp\u003ePreferred\u0026nbsp;medication\u0026nbsp;for resuscitation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.161616161616163%\"\u003e\n \u003cp\u003e197(89.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\"\u003e\n \u003cp\u003e23(10.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"64.64646464646465%\"\u003e\n \u003cp\u003eImmediately\u0026nbsp;after\u0026nbsp;delivery\u0026nbsp;newborn\u0026nbsp;should\u0026nbsp;be\u0026nbsp;placed\u0026nbsp;on\u0026nbsp;the\u0026nbsp;abdomen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.161616161616163%\"\u003e\n \u003cp\u003e188(85.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\"\u003e\n \u003cp\u003e32(14.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"64.64646464646465%\"\u003e\n \u003cp\u003eMask\u0026nbsp;covers\u0026nbsp;mouth,\u0026nbsp;nose\u0026nbsp;and\u0026nbsp;tip\u0026nbsp;of\u0026nbsp;chine\u0026nbsp;during\u0026nbsp;resuscitation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.161616161616163%\"\u003e\n \u003cp\u003e40(18.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\"\u003e\n \u003cp\u003e180(81.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"64.64646464646465%\"\u003e\n \u003cp\u003eRatio\u0026nbsp;of\u0026nbsp;chest\u0026nbsp;compression\u0026nbsp;to\u0026nbsp;ventilation\u0026nbsp;3:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.161616161616163%\"\u003e\n \u003cp\u003e185(84.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\"\u003e\n \u003cp\u003e35(15.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"64.64646464646465%\"\u003e\n \u003cp\u003eIndication\u0026nbsp;to\u0026nbsp;start volume\u0026nbsp;expander\u0026nbsp;shock\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.161616161616163%\"\u003e\n \u003cp\u003e192(87.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\"\u003e\n \u003cp\u003e28(12.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"64.64646464646465%\"\u003e\n \u003cp\u003eBaby\u0026nbsp;not\u0026nbsp;respond\u0026nbsp;for\u0026nbsp;initial\u0026nbsp;step\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.161616161616163%\"\u003e\n \u003cp\u003e85(38.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\"\u003e\n \u003cp\u003e135(61.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"64.64646464646465%\"\u003e\n \u003cp\u003eIndications\u0026nbsp;to\u0026nbsp;suction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.161616161616163%\"\u003e\n \u003cp\u003e171(77.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\"\u003e\n \u003cp\u003e49(22.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"64.64646464646465%\"\u003e\n \u003cp\u003eIndication\u0026nbsp;to\u0026nbsp;start\u0026nbsp;chest compression\u0026nbsp;HR\u0026lt;60\u0026nbsp;Bits\u0026nbsp;per\u0026nbsp;min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.161616161616163%\"\u003e\n \u003cp\u003e143(65.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\"\u003e\n \u003cp\u003e77(35%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"64.64646464646465%\"\u003e\n \u003cp\u003eCorrective\u0026nbsp;measure\u0026nbsp;if\u0026nbsp;chest not\u0026nbsp;moving\u0026nbsp;during\u0026nbsp;BMV,\u0026nbsp;reapply\u0026nbsp;the\u0026nbsp;mask.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.161616161616163%\"\u003e\n \u003cp\u003e163(74.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\"\u003e\n \u003cp\u003e57(25.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"64.64646464646465%\"\u003e\n \u003cp\u003eVentilation\u0026nbsp;should\u0026nbsp;be\u0026nbsp;commenced within\u0026nbsp;one\u0026nbsp;minute\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.161616161616163%\"\u003e\n \u003cp\u003e105(47.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\"\u003e\n \u003cp\u003e115(52.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"64.64646464646465%\"\u003e\n \u003cp\u003eChest\u0026nbsp;compression\u0026nbsp;techniques\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.161616161616163%\"\u003e\n \u003cp\u003e144(65.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\"\u003e\n \u003cp\u003e75(34.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"64.64646464646465%\"\u003e\n \u003cp\u003eA\u0026nbsp;measure\u0026nbsp;that can\u0026nbsp;be\u0026nbsp;done\u0026nbsp;for\u0026nbsp;persistent apnea\u0026nbsp;after\u0026nbsp;birth.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.161616161616163%\"\u003e\n \u003cp\u003e132(60.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\"\u003e\n \u003cp\u003e88(40.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"64.64646464646465%\"\u003e\n \u003cp\u003eThe depth\u0026nbsp;of\u0026nbsp;chest compression\u0026nbsp;is\u0026nbsp;1/3rd\u0026nbsp;of\u0026nbsp;the\u0026nbsp;anterior-posterior\u0026nbsp;diameter.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.161616161616163%\"\u003e\n \u003cp\u003e152(69.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\"\u003e\n \u003cp\u003e68(30.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"64.64646464646465%\"\u003e\n \u003cp\u003eAssessing\u0026nbsp;the\u0026nbsp;HR of\u0026nbsp;the\u0026nbsp;baby\u0026nbsp;within\u0026nbsp;30\u0026nbsp;seconds\u0026nbsp;after\u0026nbsp;giving\u0026nbsp;epinephrine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.161616161616163%\"\u003e\n \u003cp\u003e57(25.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\"\u003e\n \u003cp\u003e163(74.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"64.64646464646465%\"\u003e\n \u003cp\u003eThe correct\u0026nbsp;method\u0026nbsp;to\u0026nbsp;stimulate\u0026nbsp;the\u0026nbsp;baby\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.161616161616163%\"\u003e\n \u003cp\u003e105(47.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\"\u003e\n \u003cp\u003e115(52.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"64.64646464646465%\"\u003e\n \u003cp\u003eHelping\u0026nbsp;to\u0026nbsp;breathe\u0026nbsp;for\u0026nbsp;baby\u0026nbsp;born\u0026nbsp;with\u0026nbsp;meconium\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.161616161616163%\"\u003e\n \u003cp\u003e41(18.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\"\u003e\n \u003cp\u003e179(81.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"64.64646464646465%\"\u003e\n \u003cp\u003eThe best\u0026nbsp;source\u0026nbsp;of\u0026nbsp;gas during\u0026nbsp;neonatal\u0026nbsp;resuscitation\u0026nbsp;room\u0026nbsp;air\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.161616161616163%\"\u003e\n \u003cp\u003e20(9.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\"\u003e\n \u003cp\u003e200(90.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003ch2\u003e\u003cbr\u003e\u003c/h2\u003e\n\u003ch2\u003eFactors Associated with knowledge level of participants towards NR\u003c/h2\u003e\n\u003cp\u003eBivariable logistic regression was carried out to identify the factors associated with the knowledge level of the participants. Then the factors with a p-value \u0026lt;0.25 were included in multivariable logistic regression. In multivariable logistic regression, the factors significantly associated with the knowledge level of the participants were; being trained in newborn resuscitation (AOR = 5.39, 95% CI [1.44-20.20]), being male (AOR = 5.80, 95% CI [1.16\u0026ndash;29.09]), belonging to a specific profession (AOR = 8.94, 95% CI [1.36-58.68]), receiving supportive supervision (AOR = 3.39, 95% CI [1.01, 11.43]), and achieving a good attitude score (AOR = 5.36, 95% CI [1.52, 18.87]). Participants who had been trained in neonatal resuscitation were nearly \u003cem\u003efive\u003c/em\u003e times more knowledgeable than their counterparts. Male participants were about \u003cem\u003efive\u003c/em\u003e times more knowledgeable than their female participants. Participants with good attitude score had \u003cem\u003efive\u0026nbsp;\u003c/em\u003etimes more likely to have good knowledge level about neonatal resuscitation as compared to those with a poor attitude. Participants who got supportive supervision had 3 times more likely to have good knowledge than those with no supportive supervision. \u0026nbsp;Compared to professionals who are nurses, midwives and medical interns, those who are practicing post-graduate resident ship programs scored high on knowledge test (Table 6).\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"96%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e6\u003c/strong\u003e\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003eBivariate and multivariate analysis of factors associated with the\u0026nbsp;Knowledge\u0026nbsp;Level of Study Participants towards Neonatal Resuscitation at Asella Referral and Teaching Hospital, South East Ethiopia,2023 (n= 220).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.75%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge Level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCOR [95%CI]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAOR [95%CI]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e(P-Value)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"54.166666666666664%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGood n(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"45.833333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePoor n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.75%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;Sex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e29(23.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e94(76.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e3.43 [1.49,7.91]\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e5.80 [1.16, 29.09] \u003cstrong\u003e*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e.033\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.23076923076923%\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e8(8.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.102564102564102%\" valign=\"top\"\u003e\n \u003cp\u003e89(91.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.94871794871795%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.820512820512821%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.75%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e20-24 yr\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e2(11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e16(88.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e.\u003c/strong\u003e18 [\u003cstrong\u003e.\u003c/strong\u003e03, \u003cstrong\u003e.\u003c/strong\u003e99]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;.05 [.003, .996]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e.050\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.23076923076923%\"\u003e\n \u003cp\u003e25-29 yr\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e14(10.1) \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.102564102564102%\" valign=\"top\"\u003e\n \u003cp\u003e125 (89.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.94871794871795%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e.\u003c/strong\u003e16 [\u003cstrong\u003e.\u003c/strong\u003e06, \u003cstrong\u003e.\u003c/strong\u003e45]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e.03 [.002, .257]\u003cstrong\u003e\u0026nbsp;*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.820512820512821%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e.002\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.23076923076923%\"\u003e\n \u003cp\u003e30-34 yr\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e12(29.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.102564102564102%\" valign=\"top\"\u003e\n \u003cp\u003e29(70.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.94871794871795%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e.\u003c/strong\u003e598 [\u003cstrong\u003e.\u003c/strong\u003e20, 1.77]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e.05 [.004, .565]\u003cstrong\u003e\u0026nbsp;*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.820512820512821%\" valign=\"top\"\u003e\n \u003cp\u003e.015\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.23076923076923%\"\u003e\n \u003cp\u003e\u0026gt;=35 yr\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e9(40.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.102564102564102%\" valign=\"top\"\u003e\n \u003cp\u003e13(59.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.94871794871795%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.820512820512821%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.75%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;Profession\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e5(15.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e27(84.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e.\u003c/strong\u003e63 [\u003cstrong\u003e.\u003c/strong\u003e18, 2.16]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e1.04 [.04, 26.92]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e.982\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.23076923076923%\"\u003e\n \u003cp\u003eMidwife\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e2(6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.102564102564102%\" valign=\"top\"\u003e\n \u003cp\u003e28(93.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.94871794871795%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e.\u003c/strong\u003e24 [\u003cstrong\u003e.\u003c/strong\u003e05, 1.24]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e.02[.001, .532] \u003cstrong\u003e*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.820512820512821%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e.020\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.23076923076923%\"\u003e\n \u003cp\u003eMedical Student\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e8(8.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.102564102564102%\" valign=\"top\"\u003e\n \u003cp\u003e92(92.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.94871794871795%\" valign=\"top\"\u003e\n \u003cp\u003e.29[.10, .86]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e7.56[.40, 142.89]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.820512820512821%\" valign=\"top\"\u003e\n \u003cp\u003e.177\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.23076923076923%\"\u003e\n \u003cp\u003ePediatric resident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e14(60.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.102564102564102%\" valign=\"top\"\u003e\n \u003cp\u003e9(39.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.94871794871795%\" valign=\"top\"\u003e\n \u003cp\u003e5.25 [1.66, 16.59]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e8.94 [1.36, 58.68] *\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.820512820512821%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e.022\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.23076923076923%\"\u003e\n \u003cp\u003eGYN-OBS resident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e8(22.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.102564102564102%\" valign=\"top\"\u003e\n \u003cp\u003e27(77.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.94871794871795%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.820512820512821%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.75%\" rowspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;Level of education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003eDegree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e7(11.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e55(88.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e.\u003c/strong\u003e13 [\u003cstrong\u003e.\u003c/strong\u003e02, \u003cstrong\u003e.\u003c/strong\u003e76]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.23076923076923%\"\u003e\n \u003cp\u003eMedical intern\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e8(8.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.102564102564102%\" valign=\"top\"\u003e\n \u003cp\u003e92(92.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.94871794871795%\" valign=\"top\"\u003e\n \u003cp\u003e.09 [.02, .50]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.820512820512821%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.23076923076923%\"\u003e\n \u003cp\u003e1st-year resident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e3(15.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.102564102564102%\" valign=\"top\"\u003e\n \u003cp\u003e17(85.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.94871794871795%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e.\u003c/strong\u003e18 [\u003cstrong\u003e.\u003c/strong\u003e02, 1.33]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e.\u003c/strong\u003e18 [.01, 3.21]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.820512820512821%\" valign=\"top\"\u003e\n \u003cp\u003e.241\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.23076923076923%\"\u003e\n \u003cp\u003e2nd -year resident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e6(35.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.102564102564102%\" valign=\"top\"\u003e\n \u003cp\u003e11(64.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.94871794871795%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e.\u003c/strong\u003e55 [.08, 3.59]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e.\u003c/strong\u003e12[.01, 2.00]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.820512820512821%\" valign=\"top\"\u003e\n \u003cp\u003e.141\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.23076923076923%\"\u003e\n \u003cp\u003e3rd-year resident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e10(66.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.102564102564102%\" valign=\"top\"\u003e\n \u003cp\u003e5(33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.94871794871795%\" valign=\"top\"\u003e\n \u003cp\u003e2.00 [.29, 13.74]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e.\u003c/strong\u003e56 [.04, 8.94]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.820512820512821%\" valign=\"top\"\u003e\n \u003cp\u003e.682\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.23076923076923%\"\u003e\n \u003cp\u003e4th-year resident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e3(50.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.102564102564102%\" valign=\"top\"\u003e\n \u003cp\u003e3(50.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.94871794871795%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.820512820512821%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.75%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNR Training\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e25(34.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e48(65.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e5.86 [2.73, 12.57]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e5.39 [1.44, 20.20] *\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e.012\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.23076923076923%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e12(8.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.102564102564102%\" valign=\"top\"\u003e\n \u003cp\u003e135(91.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.94871794871795%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.820512820512821%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.75%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAttitude towards NR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003ePoor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e9(7.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e107(92.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.23076923076923%\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e28(26.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.102564102564102%\" valign=\"top\"\u003e\n \u003cp\u003e76(73.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.94871794871795%\" valign=\"top\"\u003e\n \u003cp\u003e4.38 [1.96, 9.81]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e5.36 [1.52, 18.87] *\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.820512820512821%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e.009\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.75%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSupportive Supervision\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e10(26.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e28(73.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e2.05 [.89, 4.70]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e3.39 [1.01, 11.43] *\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e.048\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.23076923076923%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e27(14.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.102564102564102%\" valign=\"top\"\u003e\n \u003cp\u003e155(85.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.94871794871795%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.820512820512821%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.75%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eWorking experience\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e\u0026lt;1 yr\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e8(7.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e101(92.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e.22[.08, .63]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e.28 [.01, 8.45]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e.465\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.23076923076923%\"\u003e\n \u003cp\u003e1-5 yr\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e20(26.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.102564102564102%\" valign=\"top\"\u003e\n \u003cp\u003e57(74.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.94871794871795%\" valign=\"top\"\u003e\n \u003cp\u003e.96 [.39, 2.44]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e1.05 [.19, 5.76]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.820512820512821%\" valign=\"top\"\u003e\n \u003cp\u003e.958\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.23076923076923%\"\u003e\n \u003cp\u003e\u0026gt;5 yr.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e9(26.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.102564102564102%\" valign=\"top\"\u003e\n \u003cp\u003e25(73.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.94871794871795%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.820512820512821%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eNote:\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e\u0026nbsp;* = S\u003c/em\u003e\u003cem\u003etatistically\u0026nbsp;\u003c/em\u003e\u003cem\u003eSignificant at p\u003cstrong\u003e-value \u0026lt; 0.05\u003c/strong\u003e, \u003cstrong\u003e1\u003c/strong\u003e= Reference, \u003cstrong\u003eCOR\u003c/strong\u003e=Crude odds ratio, \u003cstrong\u003eAOR\u003c/strong\u003e=Adjusted odds ratio, \u003cstrong\u003eCI\u003c/strong\u003e=Confidence interval,\u0026nbsp;\u003c/em\u003e\u003cstrong\u003e\u003cem\u003eNR\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e=neonatal resuscitation.\u003c/em\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study revealed that health professionals\u0026rsquo; knowledge of neonatal resuscitation was inadequate. Approximately 83.2% of participants demonstrated insufficient knowledge towards neonatal resuscitation. This poor level knowledge could lead to incorrect practices of the procedure, negatively affecting newborns outcomes. The overall mean knowledge score among participants was 65.5%, falling below the acceptable threshold of 80%.\u0026nbsp;This finding aligns with similar studies conducted in Kenya and Ethiopia(19,24,28).\u0026nbsp;The low knowledge score may be attributed to a lack of consistent and ongoing training\u0026nbsp;and supportive supervision to maintain knowledge of\u0026nbsp;health professionals\u0026nbsp;up to date,\u0026nbsp;as well as limited inclusion of neonatal resuscitation protocols in undergraduate health professional education programs.\u0026nbsp;To address this, continuous training and updates are essential for health professionals to maintain their knowledge and skills in this critical area.\u0026nbsp;This \u003cstrong\u003eknowledge scores\u003c/strong\u003e of the participants were \u003cstrong\u003ehigher\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003ecompared to other studies conducted in\u0026nbsp;Kenya (35.4%)(28), Ghana (38%)(13), study from Ethiopia mean knowledge score of 50%(29), The possible explanations could be due to differences in the qualifications of the participants, the study area, and the extent of training \u0026nbsp;and supportive supervision given for health care providers. There might also be variation in the health care systems and policies across the countries. These factors, partly cited by studies conducted in developing countries, highlight the complexity of maintaining consistent knowledge levels among healthcare professionals(24).\u003c/p\u003e\n\u003cp\u003eIn this study, midwives exhibited a suboptimal mean knowledge score (60.9%). This finding was in parallel with a study done in Afghanistan (66% mean score)\u0026nbsp;(23), Ghana( mean score of 61.8%)\u0026nbsp;(13), and South wollo,Ethiopia (66.8% mean score)\u0026nbsp;(30). However, our result surpassed that of a study conducted in North West Ethiopia, where the mean knowledge score was 42.8%.\u0026nbsp;(19). The difference might be quality of training, educational level improvement and exposure of the participants for advanced neonatal resuscitation procedure. The variation could be attributed to differences in training quality, educational advancements, and exposure to advanced neonatal resuscitation procedures.\u003c/p\u003e\n\u003cp\u003eFrom this study it was found that the mean knowledge score of nurses was poor (65.6%).\u0026nbsp;This finding was comparable with a similar study conducted in India (57%), as well as studies done in Nepal (66%) and South Wollo, Ethiopia (64.5%)\u0026nbsp;(30\u0026ndash;32). However, the nurses\u0026rsquo; knowledge score was higher than that reported in a study from the Gondar Teaching Hospital, Ethiopia (43.9%)(19), and \u0026nbsp;another study conducted in a selected public hospital in Addis Ababa, Ethiopia (46%)\u0026nbsp;(25).\u0026nbsp;The discrepancy in knowledge levels could be attributed to factors such as differences in attitudes toward neonatal resuscitation, variations in specialized training, and disparities in healthcare facility settings.\u003c/p\u003e\n\u003cp\u003eThe Mean knowledge scores of pediatric and Gyni-Obs residents were 78.9% and 68.3% respectively. These result were higher than study done in Gondar Teaching Hospital (42.8%) for pediatric residents, and (42.6%) for Gyni-Obs residents)\u0026nbsp;(19), (74.5%) for pediatric residents from study in\u0026nbsp;public hospitals of Addis Ababa(20), and from the findings observed among Pediatric residents at Khartoum University, Sudan (51.9%) from\u0026nbsp;the result of a study among\u0026nbsp;Pediatric residents in Khartoum University, Sudan (51.9%)(33). But, the result for Gyni-Obs residents were lower than study done in\u0026nbsp;public hospitals of Addis Ababa (77%)(20). The disparity in knowledge levels could be attributed to variations in neonatal resuscitation facilities and the quality of training provided to the residents. However, the knowledge scores of Gyni-Obs residents were comparable to those reported in a study conducted in India (69.1%)\u0026nbsp;(34), and among Iraqi residents (68%)\u0026nbsp;(35).\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOur study revealed that medical interns had a suboptimal mean knowledge score (62.8%). This low-level score might be due the current teaching curriculum does not provide necessary training for fresh graduates to be competent in neonatal resuscitation. The finding of this study was higher than two other studies conducted in India, where knowledge scores were reported as 54.6% and 48.6%\u0026nbsp;(34,36). The discrepancy might be due to the differences in the study area, and variations in teaching curriculum and policies across different countries.\u003c/p\u003e\n\u003cp\u003eThis study shows that,\u0026nbsp;being trained in newborn resuscitation (AOR = 5.39, 95% CI [1.44-20.20]), being male (AOR = 5.80, 95% CI [1.16\u0026ndash;29.09]), belonging to a specific profession (AOR = 8.94, 95% CI [1.36-58.68]), receiving supportive supervision (AOR = 3.39, 95% CI [1.01, 11.43]), and achieving a good attitude score (AOR = 5.36, 95% CI [1.52, 18.87])\u0026nbsp;were significantly associated with knowledge level of health professionals. This was \u0026nbsp;similar to study done in Afghanistan, India, Ghana and Ethiopia revealed training had a forward impact on health professionals\u0026rsquo; knowledge(13,23,24,37). In this study, a positive attitude among health professionals was strongly linked to their level of knowledge. This correlation aligns with findings from a Tanzanian study\u0026nbsp;(38). The possible reasons include feelings of non-caring, fear, and anxiety related to their caregiving responsibilities, as well as a perception that their professional role is not central. Encouraging a more positive attitude could potentially enhance health professionals\u0026rsquo; knowledge. To achieve this, improving the quality and frequency of training is essential. Additionally, our study revealed a significant relationship between respondents\u0026rsquo; sex and their knowledge of neonatal resuscitation, consistent with other studies\u0026nbsp;(16,19). Male participants tend to have better knowledge compared to female participants. This could be probably because women might not actively participate in the resuscitation activities\u003cbr\u003e\u0026nbsp;since there are cultural influences where most women are reserved to be involved in different occasions especially in developing countries like Ethiopia, may contribute to this disparity. However, it\u0026rsquo;s important to note that despite statistical significance, generalizing this finding remains challenging due to our small sample size.\u003c/p\u003e\n\u003cp\u003eIn this study, it was found that supportive getting supervision were strongly associated with the knowledge level of health professionals. This finding aligns with research conducted in Afghanistan, where training combined with supportive supervision was significantly associated with higher knowledge score(23).\u0026nbsp;This study also found that there is significant association between respondents aged 25 to 29 years and a good knowledge level of neonatal resuscitation (NR). This finding was against with previous study conducted in Ethiopia. The discrepancy could be attributed to methodological differences, including study participant selection, sample characteristics, and study design. It\u0026rsquo;s possible that individuals within the specified age group have recently performed and received training on NR, influencing their knowledge levels\u0026nbsp;(19).\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eLimitation of the Study \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eThe tool used to assess knowledge on neonatal resuscitation (NR) was self-administered, and health professionals were busy at work while the data were being collected, they might not give accurate information about the knowledge. This issue might negatively affect the study findings. Additionally, the causal association was under caution, as the study design was cross-sectional. Furthermore, the study was conducted at a single teaching government hospital, and the sample size is small, which limits the generalizability of results. Therefore, Readers should take these factors into account when interpreting the study\u0026rsquo;s findings.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study concluded a most of the study participants have inadequate knowledge towards Neonatal Resuscitation. Only 16.8% of the respondents had adequate level of knowledge toward neonatal resuscitation. Receiving training in neonatal resuscitation, having supportive supervision, belonging to a specific profession, being male, and achieving a good Attitude score were Factors significantly associated with participants\u0026rsquo; knowledge level.\u0026nbsp;Therefore, to improve knowledge retention, it is recommended to organize regular and simulation-based neonatal resuscitation training. Furthermore, incorporating basic neonatal resuscitation procedures into both undergraduate and postgraduate medical education can enhance students\u0026rsquo; knowledge as they serve in the community.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRecommendation\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eMinistry of health should strengthen long-term training programs in neonatology and\u0026nbsp;pediatric fields for nurses, midwifes, medical students and residents. Because specialization in these fields can\u0026nbsp;improve\u0026nbsp;towards\u0026nbsp;neonatal resuscitation.\u003c/li\u003e\n \u003cli\u003eHospital managers and decision makers in collaboration with regional and zonal health\u0026nbsp;bureau should strengthen continuous and regular training on neonatal resuscitation for Health professionals.\u003c/li\u003e\n \u003cli\u003eHospital\u0026nbsp;managers\u0026nbsp;and\u0026nbsp;decision\u0026nbsp;makers\u0026nbsp;also\u0026nbsp;need\u0026nbsp;to\u0026nbsp;provide\u0026nbsp;periodic\u0026nbsp;supportive\u0026nbsp;supervision\u0026nbsp;and refreshment training for\u0026nbsp;updating knowledge.\u003c/li\u003e\n \u003cli\u003eDifferent NGOs should contribute to the health care system by delivering training for health professionals and give supportive supervision to provide quality care.\u0026nbsp;\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cstrong\u003eARTH\u003c/strong\u003e: Asella Referral and Teaching Hospital; \u003cstrong\u003eAHA:\u0026nbsp;\u003c/strong\u003eAmerican Heart Association; \u0026nbsp;\u003cstrong\u003eBMV\u003c/strong\u003e: Bag and Mask Ventilation; \u0026nbsp;\u003cstrong\u003eCPAP\u003c/strong\u003e: Continues Positive Air way pressure; \u0026nbsp;\u003cstrong\u003eEDHS\u003c/strong\u003e: Ethiopian Demographic Health Survey; \u0026nbsp;\u003cstrong\u003eGDA\u003c/strong\u003e, Global Developmental Alliances; \u0026nbsp;\u003cstrong\u003eGYN-OBS\u003c/strong\u003e: Gynecology and Obstetrics; \u0026nbsp;\u003cstrong\u003eHBB\u003c/strong\u003e: Helping Baby Breath; \u0026nbsp;\u003cstrong\u003eHCP\u003c/strong\u003e: Health Care Professionals; \u0026nbsp;\u003cstrong\u003eIRRB,\u003c/strong\u003e Institutional Research Review Board;\u003cstrong\u003e\u0026nbsp;LMICs\u003c/strong\u003e:Low and Middle-Income Countries; \u0026nbsp;\u003cstrong\u003eMDG\u003c/strong\u003e: Millennium Development Goal; \u0026nbsp; \u003cstrong\u003eNICU\u003c/strong\u003e: Neonatal Intensive Care Unit; \u0026nbsp;\u003cstrong\u003eNR:\u0026nbsp;\u003c/strong\u003eNeonatal Resuscitation; \u0026nbsp;\u003cstrong\u003eNRP:\u0026nbsp;\u003c/strong\u003eNeonatal Resuscitation Program; \u0026nbsp;\u003cstrong\u003ePPV\u003c/strong\u003e: Positive Pressure Ventilation; \u003cstrong\u003eSSA\u003c/strong\u003e: Sub-Sharan Africa; \u003cstrong\u003eU5MR\u003c/strong\u003e: under-five mortality rate.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eAcknowledgement\u003c/p\u003e\n\u003cp\u003eThe authors are glad to forward their appreciation to Arsi University College Health Science for offering financial support to take on this research project. Our thanks also go to our data collectors, the participants involved in the study, and all our hospital staff members for their collaboration during data collection period. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAuthors\u0026rsquo; contributions\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eMW;\u0026nbsp;\u003c/strong\u003econtributed to the conception and design of the study, proposal development, data collection, analysis, review and preparation of the manuscript. \u003cstrong\u003eBS, HZ, TA,\u0026nbsp;\u003c/strong\u003eand\u003cstrong\u003e\u0026nbsp;TG;\u0026nbsp;\u003c/strong\u003econtributed to design and proposal development,\u0026nbsp;assisted during\u0026nbsp;analysis, and\u0026nbsp;a critical review of the document and revision of the manuscript. All authors read and approved the final manuscript\u0026nbsp;for publication and\u0026nbsp;agreed to be accountable for all aspects of the work.\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eFunding for this research was obtained from the \u0026lsquo;Research and Publication Office\u0026rsquo; of Arsi University College of Health Sciences\u0026nbsp;for the data collection and stationary materials of the research project. \u0026ldquo;The institution which provided the fund had no part in study design, data collection, and analysis of the findings, verdict to publish, or preparation of the manuscript.\u0026rdquo;\u003c/p\u003e\n\u003cp\u003eAvailability of data and Sharing Statement\u003c/p\u003e\n\u003cp\u003eAll data has been provided within the manuscript. The dataset supporting the conclusions of this article is available from the authors upon reasonable request.\u003c/p\u003e\n\u003cp\u003eEthical approval and consent to participate\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from the Ethical Review Committee (ERC) of Arsi University College of Health Science [Protocol No. \u003cstrong\u003eA/CHS/RC/73/2023\u003c/strong\u003e]. Formal letter of permission was also obtained from Asella Teaching and Referral hospital administrative office.\u0026nbsp;Informed consent was obtained from each participant after an explanation of what study they will be involved in. The respondents were assured of confidentiality where no unauthorized person has access to the information and names.\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eNOT APPLICABLE for this segment.\u003c/p\u003e\n\u003cp\u003eDeclaration of Conflicting Interests\u003c/p\u003e\n\u003cp\u003eThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003ePediatric Medicine / Resuscitation / Definition of Neonatal Resuscitation. 2017;(August):2017. Available from: https://en.wikibooks.org/w/index.php\u003c/li\u003e\n\u003cli\u003eKamath-Rayne BD, Thukral A, Visick MK, Schoen E, Amick E, Deorari A, et al. Helping Babies Breathe, second edition: A model for strengthening educational programs to increase global newborn survival. Glob Heal Sci Pract. 2018;6(3):538\u0026ndash;51. \u003c/li\u003e\n\u003cli\u003eJanet S, Carrara VI, Simpson JA, War N, Thin W, Say W, et al. Early neonatal mortality and neurological outcomes of neonatal resuscitation in a resource-limited setting on the Thailand- Myanmar border : A descriptive study. 2018;30:1\u0026ndash;14. \u003c/li\u003e\n\u003cli\u003eNiland N, Pearce AP, Naumann DN, O\u0026rsquo;Reilly D, Series PB, Sataloff RT, et al. World health statistics 2020 [Internet]. Vol. 167, Global Health. 2020. 1\u0026ndash;5 p. Available from: https://www.e-ir.info/2018/01/14/securitisation-theory-an-introduction/\u003c/li\u003e\n\u003cli\u003eUsman F, Imam A, Farouk ZL, Dayyabu AL. Newborn Mortality in Sub-Saharan Africa: Why is Perinatal Asphyxia Still a Major Cause? Ann Glob Heal [Internet]. 2019 Aug 8;85(1). Available from: https://europepmc.org/articles/PMC6688545\u003c/li\u003e\n\u003cli\u003eThe DHS Program - Ethiopia: DHS, 2019 - Mini Final Report (English) [Internet]. Available from: https://dhsprogram.com/publications/publication-FR363-DHS-Final-Reports.cfm\u003c/li\u003e\n\u003cli\u003eMsemo G, Massawe A, Mmbando D, Rusibamayila N, Manji K, Kidanto HL, et al. Newborn mortality and fresh stillbirth rates in Tanzania after helping babies breathe training. Pediatrics. 2013;131(2). \u003c/li\u003e\n\u003cli\u003eMasaba BB, Mmusi-Phetoe RM. Neonatal Survival in Sub-Sahara: A Review of Kenya and South Africa. 2020; \u003c/li\u003e\n\u003cli\u003eLiu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, et al. Global, regional, and national causes of under-5 mortality in 2000\u0026ndash;15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet. 2016 Dec 17;388(10063):3027\u0026ndash;35. \u003c/li\u003e\n\u003cli\u003eSpinozzi P. Death. The Palgrave Handbook of Utopian and Dystopian Literatures. 2022. 699\u0026ndash;710 p. \u003c/li\u003e\n\u003cli\u003eMoshiro R, Mdoe P, Perlman JM. A Global View of Neonatal Asphyxia and Resuscitation. Front Pediatr. 2019 Nov 26;7:489. \u003c/li\u003e\n\u003cli\u003ePammi M, Dempsey EM, Ryan CA, Barrington KJ. Newborn Resuscitation Training Programmes Reduce Early Neonatal Mortality. Neonatology. 2016;110(3):210\u0026ndash;24. \u003c/li\u003e\n\u003cli\u003eAlhassan A, Fuseini A-G, Osman W, Basour Adam A. Knowledge and Experience of Neonatal Resuscitation among Midwives in Tamale. Nurs Res Pract. 2019 Jan 2;2019:1\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eSintayehu Y, Desalew A, Geda B, Shiferaw K, Tiruye G, Mulatu T, et al. Knowledge of basic neonatal resuscitation and associated factors among midwives and nurses in public health institutions in Eastern Ethiopia. Int J Gen Med. 2020;13:225\u0026ndash;33. \u003c/li\u003e\n\u003cli\u003eBiset G, Habte T, Dugasa B, Bizuwork K. Nurses\u0026rsquo; and midwives\u0026rsquo; knowledge regarding neonatal resuscitation in public hospitals of south wollo zone of Amhara Region, Northern Ethiopia. Int J Africa Nurs Sci. 2023;18(January):100527. \u003c/li\u003e\n\u003cli\u003eAsmamaw Bekele F, Tezera Assimamaw N, Seid Ali M. Knowledge and associated factors towards neonatal resuscitation among nurses and midwives at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Int J Africa Nurs Sci. 2021 Jan 1;15. \u003c/li\u003e\n\u003cli\u003eSoti H, Gautam S, Paudel S, Bhattarai M. Knowledge regarding resuscitation of newborn among nurses . 2021;25(3):452\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eSuresh PM, Kumar TR, Nagalekshmi R, Anandan H. Evaluation of Knowledge and Practices on Neonatal Resuscitation among Nurses in Kanyakumari District Hospitals. Int J Sci Study [Internet]. 2017;5(1):166\u0026ndash;8. Available from: http://galaxyjeevandhara.com/index.php/ijss/article/view/674\u003c/li\u003e\n\u003cli\u003eGebreegziabher E, Aregawi A, Getinet H. Knowledge and skills of neonatal resuscitation of health professionals at a university teaching hospital of Northwest Ethiopia. World J Emerg Med. 2014;5(3):196. \u003c/li\u003e\n\u003cli\u003eFatuma A. Knowledge and Practice of Neonatal Resuscitation and Its Associated Factors among Health Professionals Working at Selected Public Hospitals of Addis Ababa. \u003c/li\u003e\n\u003cli\u003eWHO. Recommendations on newborn health: approved by the WHO Guidelines Review Committee. Who. 2017;(May):1\u0026ndash;28. \u003c/li\u003e\n\u003cli\u003eAziz K, Lee HC, Escobedo MB, Hoover A V., Kamath-Rayne BD, Kapadia VS, et al. Part 5: Neonatal Resuscitation: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2020;142(16 2):S524\u0026ndash;50. \u003c/li\u003e\n\u003cli\u003eKim YM, Ansari N, Kols A, Tappis H, Currie S, Zainullah P, et al. Assessing the capacity for newborn resuscitation and factors associated with providers\u0026rsquo; knowledge and skills: A cross-sectional study in Afghanistan. BMC Pediatr. 2013 Sep 10;13(1):1\u0026ndash;12. \u003c/li\u003e\n\u003cli\u003eAbrha MW, Asresu TT, Araya AA, Weldearegay HG. Healthcare Professionals \u0026rsquo; Knowledge of Neonatal Resuscitation in Ethiopia : Analysis from 2016 National Emergency Obstetric and Newborn Care Survey. 2019;2019:1\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eBogale M, Hussen H, Tefera M, Busse H. Original article assessment of knowledge of nicu nurses and midwives in neonatal resuscitation in four urban hospitals in addis ababa, ethiopia. 2021;XVI(2). \u003c/li\u003e\n\u003cli\u003eWHO technical specifications of neonatal resuscitation devices. \u003c/li\u003e\n\u003cli\u003ePatterson J, Worku B, Jones D, Clary A, Ramaswamy R, Bose C. Ethiopian Pediatric Society Quality Improvement Initiative: a pragmatic approach to facility-based quality improvement in low-resource settings. BMJ Open Qual. 2021;10(1). \u003c/li\u003e\n\u003cli\u003eMurila F, Obimbo MM, Musoke R. Assessment of knowledge on neonatal resuscitation amongst health care providers in Kenya. Pan Afr Med J. 2012;11:78. \u003c/li\u003e\n\u003cli\u003eHaile-Mariam A, Tesfaye N, Otterness C, Bailey PE. Assessing the health system\u0026rsquo;s capacity to conduct neonatal resuscitation in Ethiopia. Ethiop Med J. 2012 Jan 1;50(1):43\u0026ndash;55. \u003c/li\u003e\n\u003cli\u003eBizuwork K, Habte T, Birkie M, Woday A. The extent of Knowledge and practice toward neonatal resuscitation among nurses and midwives in public hospitals of South Wollo , northeast Ethiopia : Cross-sectional study. 2019;1\u0026ndash;18. \u003c/li\u003e\n\u003cli\u003eOpiyo N, Were F, Govedi F, Fegan G, Wasunna A, English M. Effect of newborn resuscitation training on health worker practices in Pumwani Hospital, Kenya. PLoS One. 2008 Feb 13;3(2). \u003c/li\u003e\n\u003cli\u003eGauro P, Saha A, Adhikari B. Knowledge and Skill of Newborn Resuscitation among Nurses Working in Maternity Ward. Int J Heal Sci Res. 2018;8(2):149\u0026ndash;54. \u003c/li\u003e\n\u003cli\u003eTREVISANUTO D, IBRAHIM SA, DOGLIONI N, SALVADORI S, FERRARESE P, ZANARDO V. Neonatal resuscitation courses for pediatric residents: comparison between Khartoum (Sudan) and Padova (Italy). Pediatr Anesth. 2007;17(1):28\u0026ndash;31. \u003c/li\u003e\n\u003cli\u003eTaksande AM. NEONATAL RESUSCITATION TRAINING PROGRAMME , ITS EFFICIENCY AT RURAL HOSPITAL. 2012;6\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eJabir MM, Doglioni N, Fadhil T, Zanardo V, Trevisanuto D. Knowledge and practical performance gained by Iraqi residents after participation to a neonatal resuscitation program course. Acta Paediatr Int J Paediatr. 2009;98(8):1265\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eGautam P, Sharma N. Assessing competency in neonatal resuscitation among medical students , interns and postgraduate students : a study from a tertiary care hospital in North India. 2022;10(9):1958\u0026ndash;62. \u003c/li\u003e\n\u003cli\u003eBansal SC, Nimbalkar AS, Patel D V., Sethi AR, Phatak AG, Nimbalkar SM. Current Neonatal Resuscitation Practices among Paediatricians in Gujarat, India. Int J Pediatr. 2014;2014:1\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eMoshiro R, Ersdal HL, Mdoe P, Kidanto HL, Mbekenga C. Factors affecting effective ventilation during newborn resuscitation: a qualitative study among midwives in rural Tanzania. Glob Health Action. 2018 Jan 1;11(1). \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pediatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bped","sideBox":"Learn more about [BMC Pediatrics](http://bmcpediatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bped/default.aspx","title":"BMC Pediatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Healthcare professionals, Knowledge, Neonatal resuscitation, Southeast Ethiopia","lastPublishedDoi":"10.21203/rs.3.rs-4208704/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4208704/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Neonatal resuscitation is a critical intervention to save newborns’ life from the state of asphyxia. When performed Effectively by knowledgeable healthcare providers, it can significantly reduce neonatal mortality and morbidity associated with birth asphyxia. However, studies have shown that many health professionals, particularly in low-resource settings like Ethiopia, lack adequate knowledge and skills in neonatal resuscitation. Therefore, this study aimed to assess the knowledge level of health professionals towards neonatal resuscitation and its associated factors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod: \u003c/strong\u003eAn institutional-based cross-sectional survey was conducted using a structured questionnaire. The survey targeted all health professionals working in the Delivery and Neonatal Intensive Care Units of the hospital. Data were entered and verified using Epi-data version 4.6 and analyzed using SPSS version 26. A binary logistic regression model was used and, a P-value \u0026lt; 0.05 with a 95% confidence interval was used to declare a statistically significant association.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The study showed that the majority, 83.2% of health professionals had poor knowledge regarding neonatal resuscitation. Factors significantly associated with a knowledge level of neonatal resuscitation were, being trained in neonatal resuscitation (AOR = 5.39, 95% CI [1.44-20.20]), being male (AOR = 5.80, 95% CI [1.16–29.09]), belonging to a specific profession (AOR = 8.94, 95% CI [1.36-58.68]), receiving supportive supervision (AOR = 3.39, 95% CI [1.01, 11.43]), and achieving a good attitude score (AOR = 5.36, 95% CI [1.52, 18.87]).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e The overall knowledge level of health professionals regarding Neonatal Resuscitation was poor. Factors significantly associated with participants’ knowledge include receiving neonatal resuscitation training, having supportive supervision, belonging to a specific profession, being male, and achieving a good Attitude score. Therefore, to improve knowledge retention, it is recommended to organize regular and simulation-based neonatal resuscitation training. Furthermore, incorporating basic neonatal resuscitation procedures into undergraduate and postgraduate medical education can enhance students’ knowledge as they serve in the community.\u003c/p\u003e","manuscriptTitle":"Knowledge level of Neonatal Resuscitation and Its Associated factors among Healthcare Professionals at Asella Referral and Teaching Hospital, in Southeast Ethiopia.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-10 16:16:02","doi":"10.21203/rs.3.rs-4208704/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-11-12T16:36:01+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-10-26T02:23:00+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-10-23T17:15:33+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-10-23T14:24:52+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-10-23T10:55:47+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-10-21T10:54:20+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-10-20T14:02:07+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"293635347778328857175584266698589170421","date":"2024-10-16T16:16:28+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"183626772875774860336588720754580956118","date":"2024-10-16T04:41:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"60232493588167029237562634039388525098","date":"2024-10-15T13:07:21+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"250975356004650438391947614281098306480","date":"2024-10-15T10:42:45+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"192066978474184398153418678552814540261","date":"2024-10-15T06:30:15+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"33016835781950471307553726451015735244","date":"2024-10-14T12:31:05+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"200111279766527860073941827196608106520","date":"2024-10-13T12:11:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"291522689745610106749432957079155085936","date":"2024-10-13T08:53:23+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"12608603219653304359794742252429345284","date":"2024-10-13T08:34:01+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-07-10T09:28:25+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-06-20T10:33:05+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-04-05T15:15:46+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-04-05T15:10:59+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pediatrics","date":"2024-04-02T20:32:32+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pediatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bped","sideBox":"Learn more about [BMC Pediatrics](http://bmcpediatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bped/default.aspx","title":"BMC Pediatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"342754b6-daa2-4fa3-a9c7-9e0f88038bdc","owner":[],"postedDate":"April 10th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-10-06T15:59:27+00:00","versionOfRecord":{"articleIdentity":"rs-4208704","link":"https://doi.org/10.1186/s12887-025-06061-1","journal":{"identity":"bmc-pediatrics","isVorOnly":false,"title":"BMC Pediatrics"},"publishedOn":"2025-09-29 15:57:03","publishedOnDateReadable":"September 29th, 2025"},"versionCreatedAt":"2024-04-10 16:16:02","video":"","vorDoi":"10.1186/s12887-025-06061-1","vorDoiUrl":"https://doi.org/10.1186/s12887-025-06061-1","workflowStages":[]},"version":"v1","identity":"rs-4208704","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4208704","identity":"rs-4208704","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}