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Received Jun 3, 2017; Revised Aug 21, 2017; Accepted Oct 1, 2017
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
1. Background
Globally, approximately 4 million deaths occur in neonates with 99 percent of them occurring in low and middle income countries [1, 2]. Global neonatal mortality rate stands at 21 per 1000 live births, with African region at 32 per 1000 live births [3] where Sub-Saharan Africa alone approximates to about 77% of the neonatal deaths [4]. Birth asphyxia has for a long time been estimated to account for approximately 25 percent of neonatal mortality worldwide [5]. This is despite the morbidity and mortality from birth asphyxia being preventable and treatable [6].
The majority of the neonatal deaths (75 percent) occur in the first week of life, with approximately half of these occurring within the first 24 hours after birth [2, 5, 7]. Significantly, the risk of death increases by 16 percent for every 30 seconds delay in initiating ventilation up to six minutes and every six percent for every minute of delay of applied bag and mask ventilation [5]. Evidence has shown that training of healthcare providers in Helping Babies Breathe intervention can contribute to a 47% reduction in early neonatal mortality [8]. This points to the need for appropriate care of these babies especially during the critical first hours of life. Therefore, efforts to improve child health have to focus on reducing neonatal deaths, in particular early deaths within the first minutes.
Effective NR could prevent neonatal deaths by 30 percent as well as improve the outcomes of newborns delivered with birth asphyxia [9]. This has been demonstrated in low resource settings in Sub-Saharan Africa and developing world [10].
In Kenya, neonatal mortality rate...
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