Competency and Barriers to Neonatal Resuscitation Among Midwives in Low-Resource Public Facilities

African Journal of Nursing and Midwifery | Vol. 14, No. 9, September 2026 | pp. 161–169

DOI: 10.46882/2026/AJNM/000150

Original Research Article

Title: Competency and Barriers to Neonatal Resuscitation Among Midwives in Low-Resource Public Facilities

Names of Authors: Abena S. Boateng¹, Kwame O. Mensah²

Authors’ Affiliations:
¹Directorate of Nursing, Komfo Anokye Teaching Hospital, Kumasi, Ghana
²Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

Abstract:
Birth asphyxia is a primary contributor to early newborn deaths, requiring swift and highly skilled resuscitation maneuvers from delivering clinicians. This study evaluated theoretical knowledge and practical resuscitation competencies among midwives working within low-resource public maternity units. A descriptive quantitative design surveyed 135 midwives across eight regional centers using a 25-item standardized knowledge tool and a validated objective checklist during hands-on neonatal simulation models. The mean score for theoretical knowledge was high at 81.2% (SD = ±5.4). However, only 39.3% of the observed midwives achieved full practical competency marks during simulated asphyxia events. The most frequent clinical errors involved incorrect ventilation pressure applications and delayed heat maintenance steps. Major barriers to performance included missing functional suction devices (64.4%) and neonatal bag-valve-mask sets (52.6%) in the delivery suites. Midwives who engaged in simulation exercises within the prior half-year achieved significantly superior score profiles (p = 0.008). The study concludes that equipment deficits and low simulation practice create dangerous operational gaps. Securing essential infant resuscitation devices and mandating frequent low-dose high-frequency practical reviews are vital.

Keywords: Neonatal Resuscitation; Midwifery Competency; Birth Asphyxia; Low-Resource Care; Equipment Shortages; Simulation Performance.

Manuscript Timeline: Received June 28, 2026; Revised August 18, 2026; Accepted September 03, 2026; Published September 16, 2026.

Citation: Boateng, A. S., & Mensah, K. O. (2026). Competency and Barriers to Neonatal Resuscitation Among Midwives in Low-Resource Public Facilities. African Journal of Nursing and Midwifery, 14(9), 161–169. DOI: 10.46882/2026/AJNM/000150

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