Newborn Head to Toe Assessment, Importance for Midwives

Abstract

Background: Comprehensive head-to-toe newborn assessment is a critical component of postnatal care that enables early detection of life-threatening conditions and congenital anomalies. In low-resource settings, however, midwives often lack the training and confidence to perform these assessments, leading to missed diagnoses and preventable complications. This study was initiated in response to repeated clinical oversights observed at Dr. Zia-ud-Din Hospital Kemari, where systematic newborn assessments were routinely omitted. Objective: To evaluate the impact of a structured educational intervention on midwives’ knowledge and clinical competency in performing newborn head-to-toe assessments. Methods: A cross-sectional interventional study was conducted over five weeks involving 12 registered midwives. Baseline knowledge was assessed using a 12-item questionnaire followed by a structured two-hour training session comprising a multimedia presentation and hands-on practice using neonatal manikins. One-week post-intervention, a subset of six midwives underwent OSCE-based evaluation. Pre- and post-test scores were compared using paired t-tests, and domain-specific performance was analyzed. Results: Mean knowledge scores improved from 58.3% (SD 1.3) to 85.0% (SD 1.1), with a mean difference of 3.2 points (95% CI, 2.2–4.1; p<0.001). All OSCE-assessed midwives achieved competency, with a mean score of 84.2% (SD 6.5). Less experienced midwives demonstrated greater relative knowledge gains. Conclusion: Targeted, evidence-based training significantly enhances midwives’ capacity to perform newborn assessments, especially among early-career professionals. Institutionalizing such interventions may improve neonatal outcomes in resource-limited settings.