Preferences and practices: Use of neonatal resuscitation devices in low-resource settings

Background: Birth asphyxia, when a baby does not breathe at birth, is estimated to account for 23% of the approximately four million neonatal deaths that occur annually. Correct use of neonatal resuscitators is critical to lower neonatal mortality rates due to birth asphyxia. Methods: In order to understand the context of use of resuscitators including use scenarios, training, device readiness and design features and preferences, PATH conducted an anonymous web-based survey among neonatal health experts. Twenty-eight percent (22/80) of experts completed the survey. Results: In general, the bag and mask devices were used by more practitioners and in more places than the tube and mask design; the tube and mask device was not well known. Features of the bag and mask device that mattered most were ease of use, mask size and device function. Features of the tube and mask device that mattered most were ease of use and availability. Device readiness at delivery and use of devices after long periods of inactivity were also concerns. Conclusions: There was a clear preference for the bag and mask device over the tube and mask device due to its ease of use. Programmatic implications include the need to improve health workers confidence in the ability of the device to be cleaned and to remain in safe working order over time. These issues should be reviewed during periodic refresher training courses.