Written by Opeyemi Odedere
Contributors: Carrie Noxon and Nicole Moreno

Birth asphyxia, also known as Hypoxic Ischemic Encephalopathy (HIC), is one of Nigeria’s most common causes of neonatal mortality and morbidity. It is a condition that occurs when a baby does not get enough oxygen during birth. The limited flow of blood and oxygen to the brain and perhaps to other organs can lead to brain damage either during delivery or soon after birth; it can also lead to death.
According to the WHO, birth asphyxia accounts for an estimated 900,000 deaths of newborns globally. Birth asphyxia occurs in most secondary health facilities in Nigeria, including facilities supported by NEST360.
While breathing in newborns is supposed to be a natural process, for some babies, assistance is required before they can breathe on their own. Care providers can help babies to breathe through neonatal resuscitation. This intervention follows the principle of keeping the airway open and clear, the baby well positioned, breathing spontaneously or assisted within 60 seconds of delivery, and ensuring the adequate circulation of oxygenated blood.
In Oyo state, one of the NEST implementing states in Nigeria, the State Ministry of Health (SMOH) has identified birth asphyxia as a priority challenge among newborn care problems. The Ministry has asked that asphyxia be addressed through preventive and treatment interventions. Because of this, the State Ministry of Health reached out to NEST360 to provide technical assistance in building the capacity of selected nurses and midwives across the whole of Oyo state who are skilled in neonatal resuscitation.
NEST360 Nigeria partnered with the office of the Special Adviser (SA) to the Governor on Public Health and the Nursing Directorate of the State Ministry of Health to develop a resuscitation training plan to ensure they train 90 nurses (three batches) in three months.
The first training sessions were held in July 2022 for 30 midwives from more than ten secondary health facilities. Many attendees saw this as a unique training opportunity where they were able to receive hands-on training with a bag and mask during simulation exercises.
The pre-assessment showed that a sizable number of the participants lacked the skills to handle bag and masks during newborn resuscitation. However, following the training, over 90% of the nurses had mastered the use of bag and masks for conducting neonatal resuscitation.
In the next two months, NEST intends to work with the office of the SA and the SMOH to conclude the trainings. This process has also encouraged the SMOH to begin making provisions to supply all secondary health facilities in the state neonatal with resuscitation kits.