Assessment of equipment and human resources in a national survey of neonatal resuscitation in Iran

Neonatal resuscitation is a critical procedure. Adequate knowledge of resuscitation, along with the availability of professionals and equipment, plays a critical role in proper management of newborns and decreases complications in neonates. The aim of this research is to provide a national evaluation of neonatal resuscitation in Iran and an assessment of related resources. This cross-sectional descriptive study was performed from June 2020 to January 2022. This survey was implemented in a national network of 674 hospitals of Iran (census), divided into three main groups based on annual number of deliveries and six main hospital types. We designed a checklist based on the American standardized neonatal resuscitation program (NRP) 2020. A team of healthcare providers in each hospital were asked to fill out the questionnaire accurately. In hospitals of this study, 337 had ≤ 1000, 232 had 1000–3000 and 105 had ≥ 3000 deliveries/year. Educational hospitals had the highest mean number of live births and stillbirths. In our study, 17.8% of hospitals had neither neonatal ward nor NICU, and only 32.5% of hospitals had a neonatologist employed. Temperature adjustment was not available in 19.1% delivery rooms. T-piece resuscitator was only available in 32.2% of hospitals. The neonatal mortality rate was reduced by the availability of pediatricians (1.73 vs. 2.11 per 1000), mandating NRP workshops (1.68 vs. 2.41 per 1000), and equipping the hospital with NICU or neonatal wards (1.71 vs. 2.01 per 1000). Lack of pediatric professionals, critical equipment, and drugs for resuscitation was considerable nationwide. A national program should be designed addressing these shortcomings to improve the quality of care.