IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Rabab Omer Mohammed Salih 1 * https://ijojournals.com/ Volume 08 || Issue 03 || March, 2025 || “Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022 Rabab Omer Mohammed Salih1. Widad Ibrahim Adbulghader2. 1. Ministry of Health Saudi Arabia. Neonatal Intensive Care Unit 2. College of Nursing, University of Bahri Rabab Omer Mohammed Salih. Hail General Hospital. ABSTRACT Immediate newborn care is the care given to newborns in the transitional period (immediately after birth) which crucial to their survival. Midwives require adequate training practice and skills to provide immediate newborn care. The study was aimed to assist the midwives working in labor room unit in Obstetrics and Gynecology Teaching Hospital to gain skills needed in the immediate care of the newborn. Quasi-experimental designstudy was conducted from February to July 2020 at Sinnar State in governmental hospitals. The sample size consisted of (96) midwives. Data were collected by using observation checklist to monitor midwives performance pre and post intervention to determine their practice regarding immediate care of newborn. Data analysis was performed by statistical package for social sciences (SPSS) (Version 26) presented in tables and figure. The results of study indicated that midwives’ IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 30 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Rabab Omer Mohammed Salih 1 * https://ijojournals.com/ Volume 08 || Issue 03 || March, 2025 || “Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." practice assessment before the implementation of training program for study sample was moderate related to immediate newborn care. All the study group were labor room and female, they had got diploma certificate. Majority(44.8%) of the study samples were ranged between (41-50) years. The highest percentage (52.5%) of study sample were attended training program in neonatal care. The total mean score of post midwives practice were (79.2%, 13.5% and 7.3%) for the done correctly, done not correctly and not done respectively. The results of the study indicated that (14.5%) of the midwives showed a good performance and after implementation practice program and conducting the post-test, the midwives expressed good performance (80.8%). There were high significant differences (P 0.01) in midwives’ practice at pretest and posttest before and after the implementation of practice program for study sample. The study findings showed that program had been an effective method of increasing the midwives’ practice about immediate newborn care. Key words: Midwives, implementation Practice, Immediate newborn care, Sudan. INTRODUCTION Essential newborn care is the care providing to the newborn babies after labor within the labor room by practiced workers which includes drying and motivating, evaluating breathing air , cord care, skin to skin contact, initiating IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 31 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Rabab Omer Mohammed Salih 1 * https://ijojournals.com/ Volume 08 || Issue 03 || March, 2025 || “Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." exclusive breastfeeding, eye care, vitamin k providing, place of identification band and weighing (Lazzerini, et al.,2019).A comparative study was done on essential newborn care practice in hospital and home deliveries in 2005 in Medan, Pakistan. This study highlighted the deficiencies in the newborn care.Both hospital practices and traditional ones neglected the basic principles of newborn cleanliness, early breast feeding, eye care and cord care(WHO.2017).Essential newborn care has standardized and active practical steps: drying and motivating, evaluating breathing, care of umbilical cord, protection the newborn warm (preventing hypothermia), starting breastfeeding within the first hour, managing eye drops / eye ointment, administering vitamin K intramuscularly, newborn identification straps, weighing the newborn, when stable and warm, write all notes and treatments, delay bathing the baby for 24 hours after birth (Roué,et al., 2017). The majority of healthcare practitioners do not practice in a proper manner. Many neonatal deaths can be avoided if necessary newborn care is provided (Arba, 2022).The World Health Organization recommends that improving ENC be emphasized as a priority activity around the time of birth in order to substantially reduce newborn mortality. Despite the implementation of many efforts to improve vital infant care, only 16.4% and 13% of newborns received skilled health workers during delivery and the postnatal period, respectively (Abdu, et al., 2019). IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 32 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Rabab Omer Mohammed Salih 1 * https://ijojournals.com/ Volume 08 || Issue 03 || March, 2025 || “Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." The majority of neonatal deaths occur in the first week of life, with asphyxiation at delivery (47.5 %), neonatal infections (34.3 %), and prematurity accounting for 93 % of NMR instances (11.1 %) (WHO,2017).According to certain research, 25 % of health care providers do not have sufficient knowledge of essential newborn care, 28 percent do not have effective essential newborn care practices, and only 9.8 % of participants in the study are informed about infant resuscitation(Berhe, et al., 2017).One technique for improving infant health outcomes is to promote ENC. This necessitates health care systems that can provide continuum of care from the onset of pregnancy (and even before), through professional competent childbirth care, and into the postnatal period. However, the standardized technique for obtaining ENC is not widely used. One of the most important parts of health systems in terms of adhering to ENC standards is knowledge (Koru, 2013). New born mortality in Sudan is estimated at (61 per 1 000). The high figure is attributed to poor neonatal care resources, and shortage of staff trained in new born care. Midwives are the first line staff to deal with neonates requiring urgent help. Neonatal care training is deficient in midwifery schools. Also there is lack of in-service training m neonatal care for hospital midwives newborn care services in Sudan have not progressed well over the years. Medical and nursing staff involved in newborn care in the delivery rooms or special care IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 33 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Rabab Omer Mohammed Salih 1 * https://ijojournals.com/ Volume 08 || Issue 03 || March, 2025 || “Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." baby units have not gained much experience in proper newborn care. The midwives are the first contact of the newborns so we need them to be knowledgeable and aware about initial care and assessment of the neonate to decrease incidence of mortality and morbidity rate by using standard process for the immediate care of newborn. For this reasons this study is conduced to provide a training program on midwives practice regarding immediate care of the newborn. METHODOLOGY A quasi-experimental design analytic study conducted to assess midwives' practice and to evaluate midwives' practices regarding immediate new born care for the study population using, the study was started at (October 2019 to August 2022). The study was performed in the labor room of Sinnar city, Obstetrics and Gynecology Teaching Hospital. The study's sample included (96) midwives who work in the labor room at the Obstetrics and Gynecology Teaching Hospital and were participating in the assessment. The samples were chosen based on the midwives who worked in the labor rooms at Sinnar city, Obstetrics and Gynecology Teaching Hospital. Inclusion criteria was all midwives working in labor room in Obstetrics and Gynecological Hospital at governmental hospital during the period of the study.An observational checklist IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 34 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Rabab Omer Mohammed Salih 1 * https://ijojournals.com/ Volume 08 || Issue 03 || March, 2025 || “Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." was developed by the researcher to observe the actual midwives performance before and after the training program. It included all midwives care and practices needed for the immediate care of the newborn. Data collected by self- administer questionnaire and checklist by researcher a questionnaire sheet was designed by the researcher in Arabic language. The questionnaire consists of two main parts includes the following: Part I: consists of midwives’ demographic characteristics such as (midwives age, level of education, number of years' service in a hospital, number of years' experience in midwifery, whether they have completed a training course for immediate newborn care, the number of training courses they have completed, and the location of their participation.). Part II: Including the checklist concerning midwives’ practices about immediate care for newborns. Consist of (17) items were divided to (5) mean group relating to midwives' practice of providing immediate care to newborns such as maintain airway clearance: (oral suctioning, nasal suctioning, and apgar score). Umbilical cord such, skin and eye: (umbilical cord, skin to skin contact, skin care, and eye care). Initiation of early breast feeding, given vitamin K: (Initiation of early breast feeding and given vitamin K). Measuring vital signs: (assess body temperature by rectal, assess heart rate and assess respiratory rate). Measuring head and chest: (head circumference, chest circumference, weight and length). Training program including theory and practice session (stimulation). The post questioner provided immediately conducting the education program, pre IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 35 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Rabab Omer Mohammed Salih 1 * https://ijojournals.com/ Volume 08 || Issue 03 || March, 2025 || “Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." and post questioner are same, and checklist used for measuring the practice. In the evaluation. The practice scenario conducted for the participant and registered in with video and checked the errors together, and deleted for those they do not want. During training program hand learning material distributed .at the end of the best participants done to handle the continues training program .fallow up done after four months and post questioner applied to the participants. Approval from University of Bahri faculty of postgraduates studies, permission of ministry of health and approval from all hospitals. Verbal informed consent was obtained from the participants, confidentiality of response to both questionnaire and personal data sheet was assured. The participant were provide essential information for consent form and their signatures taken on consent form. The participant have right to with draw from the study at any time and that there would be no potential physical economical or legal harm to the participants. The result available and given the hospital. SPSS (Statistical Package for Social Sciences) version 26.0 and excel is used to examine the data. It includes: data of this study analyzed descriptive by identifying the change and the percentage, frequency, standard deviation and mean of score. Also means determining the outcome. And Inferential Statistical Tests (t-test and repeated measure ANOVA). IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 36 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Rabab Omer Mohammed Salih 1 * https://ijojournals.com/ Volume 08 || Issue 03 || March, 2025 || “Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." RESULTS Table (1): Demographic characteristics of study group n=96 Items Frequency Percent Age 20-30 years 05 4.2% 31-40 years 27 28.1% 41-50 years 42 44.8% More than 50years 22 22.9% Total 96 100% Gender Female 96 100% level of qualification Diploma 96 100% Field of study Midwifery 96 100% years of experience 6 – 11 Years 34 35.4% 11 – 15 Years 12 12.5% More than 15 Years 50 52.1% Total 96 100% Unite of work Labor room 96 100% Last attended training and participation in training courses in neonatal care Yes 50 52.5% IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 37 IJO - INTERNATIONAL JOURNA ( ISSN: 2814-2098 ) https://ijojournals.com/ “Effect of Training Program on Midwives Practice Regard The table showed that all the study group room and female. Majority(44.8%) were ranged between (41 highest percentage (52.1%) of study sample has training courses in immediate newborn care. Fig. (1). Performance of study group during Maintain dry and warm newborn after birth n= 96 No Total INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING Rabab Omer Mohammed Salih Volume 08 || Issue 03 || March Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022 The table showed that all the study group were got diploma certificate, Majority(44.8%) were ranged between (41-50) years. highest percentage (52.1%) of study sample has training courses in immediate Fig. (1). Performance of study group during Maintain dry and warm 46 47.5% 96 100% AND NURSING Rabab Omer Mohammed Salih 1 * March, 2025 || ing Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." got diploma certificate, labor 50) years. The highest percentage (52.1%) of study sample has training courses in immediate Fig. (1). Performance of study group during Maintain dry and warm for the 47.5% 100% IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 38 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Rabab Omer Mohammed Salih 1 * https://ijojournals.com/ Volume 08 || Issue 03 || March, 2025 || “Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." Data in fig (1). Midwives practice during maintain dry and warm for the newborn after birth were (80.3%, 10.4% and 6.3%) for the done correctly, done not correctly and not done respectively. Table (2). Performance of study group during midwives practice items in immediate care of newborn pre and post n=96 Done correctly answers Pre test Post test f % f % Maintain airway clearance Oral suctioning 13 13.5% 73 76% Nasal suctioning 10 10.4% 71 70.4% Apgar score 10 10.4% 71 70.4% Mean score 11 11.3% 72 74.3% nursing care (umbilical cord, skin and eye) Umbilical cord 09 9.4% 79 82.2% Skin to skin contact 12 12.5% 83 86.5% Skin care 15 15.6% 80 83.3% Eye care 18 18.8% 82 85.4% Mean score 14 12.9% 81 79.5% nursing care (Initiation of early breast feeding, given vitamin K) IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 39 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Rabab Omer Mohammed Salih 1 * https://ijojournals.com/ Volume 08 || Issue 03 || March, 2025 || “Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." Initiation of early breast feeding 19 19.8% 78 81.4% Given vitamin K 43 44.8% 85 88.5% Mean score 31 23.3% 82 84.9% Whereas, f= frequency, %= percent. This table presents that the mean scores midwives practice for pre and post- test about immediate newborn care; the mean score indicate that midwives practice were increased from (11.3%, 12.9% and 23.3%) to (74.3%, 79.5% and 84.9%) for maintain airway clearance, umbilical cord, skin and eye and Initiation of early breast feeding, given vitamin K respectively. Table (3). Performance of study group during midwives practice items in immediate care of newborn pre and post n=96 Correctly answers Pre test Post test F % f % measuring vital signs in immediate care of newborn Assess body temperature by rectal 10 10.4% 78 81.3% Assess heart rate 15 15.6% 78 81.3% Assess respiratory rate 07 07.5% 81 84.4% Mean score 11 11.7% 80 82.3 IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 40 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Rabab Omer Mohammed Salih 1 * https://ijojournals.com/ Volume 08 || Issue 03 || March, 2025 || “Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." measuring head and chest circumference weight and length newborn after birth Head circumference 07 07.3% 78 81.3% Chest circumference 08 08.3% 82 85.4% Weight 18 18.6% 77 80.2% Length 17 17.7% 81 84.4% Means score 13 12.8% 80 82.8% Whereas, f= frequency, %= percent. This table presents that the mean scores midwives practice for pre and post- test about immediate newborn care; the mean score indicate that midwives practice were increased from (11.7% and 12.8%) to (82.3% and 82.8) for measuring vital signs in immediate care of newborn and measuring head and chest circumference weight and length newborn after birth respectively. Table (4) Mean of performance of study group during nursing care pre and post n=96 Nursing practices Pre test Post test t Sig. (2- tailed) X±SD X±SD Performance of study group during Maintain dry and 11.4±1.8 74.3±3.4 -28.5 0.00** IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 41 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Rabab Omer Mohammed Salih 1 * https://ijojournals.com/ Volume 08 || Issue 03 || March, 2025 || “Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." warm, airway clearance and Apgar score Performance of study group during nursing care (umbilical cord, skin and eye) 12.9±6.0 79.5±2.4 -20.6 0.00** Performance of study group during nursing care (Initiation of early breast feeding, given vitamin K) 23±17.6 84.9±5.1 -19.8 0.008* Performance of study group during measuring vital signs 11.7±4.1 82.3±1.7 -27.5 0.00** Performance of study group during measuring head and chest circumference weight and length newborn after birth 12.8±6.1 82.8±2.5 -21.5 0.00** Whereas, X = mean, t = t-test, SD = standard deviation. Sig. =Significant at p-value = 0.05 Data in table (4), reveals that there was significant relationship between midwives’ pre and post practices with regard to their participation in training IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 42 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Rabab Omer Mohammed Salih 1 * https://ijojournals.com/ Volume 08 || Issue 03 || March, 2025 || “Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." program about assessment of immediate newborn care at (Sig. (2-tailed) 0.01)). Table (5): Comparing between pre and post training program regarding midwives immediate care of newborn n= 96 Item X±SD t Sig. (2-tailed) Pre total mean practice 14.5 ± 5.0 -22.3 0.00** Post total mean practice 80.8 ± 4.1 Whereas, X = mean, t = t-test, SD = standard deviation. Sig. =Significant at p-value = 0.05 Data in table (5), reveals that there was significant relationship between midwives’ pre and post practices with regard to their participation in training program about assessment of immediate newborn care at (Sig. (2-tailed) 0.01)). Table (6): Distribution of study group according to their performance pre and post-testn= 96 Nursing performance Level of performance Pre test Post test t Sig. (2- tailed) Level of performance X±SD X±SD Good performance 16.8±8.2 75.7±8.3 - 11.3 0.00** IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 43 IJO - INTERNATIONAL JOURNA ( ISSN: 2814-2098 ) https://ijojournals.com/ “Effect of Training Program on Midwives Practice Regard Satisfied performance Poor performance Whereas X = mean, t = t-test, value = 0.05, Data in table (6), reveals that there midwives’ performance from pre and post midwives their participation in training care at (Sig. (2-tailed) 0.00 Fig (2). Total mean score of midwives practice for done correctly, done no correctly and not doe answers n INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING Rabab Omer Mohammed Salih Volume 08 || Issue 03 || March Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022 Satisfied performance 39.2±14.6 13.6±7.6 3.4 Poor performance 40.1±18.4 6.8±1.2 4.04 test, SD = standard deviation, Sig. =Significant at p reveals that there was significant relationship between performance from pre and post midwives practices with regard to their participation in training program about assessment of immediate newborn 0.001)). ean score of midwives practice for done correctly, done no correctly and not doe answers n= 96 AND NURSING Rabab Omer Mohammed Salih 1 * March, 2025 || ing Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." 0.008** 4.04 0.004** , Sig. =Significant at p- significant relationship between practices with regard to of immediate newborn ean score of midwives practice for done correctly, done not IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 44 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Rabab Omer Mohammed Salih 1 * https://ijojournals.com/ Volume 08 || Issue 03 || March, 2025 || “Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." Data in fig (2). Showed the total mean score of midwives practice for done correctly, done not correctly and not doe answers for pre and post midwives practice. The total mean score of post midwives practice were (79.2%, 40.6% and 7.3%) for the done correctly, done not correctly and not done respectively. DISCUSSION According to their Demographic Characteristics The current study showed that more than half of the participants (44.8%) were above forty years in age. Contradicted with findings were reported in other intervention study in Sudan, in Khartoum state (Rabab and Buthina. 2022) and found that the majority of their participants (74.5%) were aged 20–30 years. Also Mohammad, (2020) who found the specified age distribution of the respondents while revealing that the highest age group is between (20 – 29) years which made up(44.7%)of the study sample. All participants in this study were female which is similar to the findings of another study in Sudan, which showed that all neonatal care nurses (100%) in the NICU were female. This can be attributed to hospital polices (Babeker, Z. A., 2015). The results show that all midwives had got diploma certificate. Contradicted with Mohammad, (2020) the results show that half of the study participants were graduates of a secondary midwifery school. The current study showed that the highest percentage (52.5%) of study sample were attended training program in neonatal care. Similar results was found by Ali, (2022), 86% of IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 45 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Rabab Omer Mohammed Salih 1 * https://ijojournals.com/ Volume 08 || Issue 03 || March, 2025 || “Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." nurse-midwives that they had taken training courses, 40 % was that they had taken 1-5 courses, and 24 % said they had taken 6-10 courses.While agreeing with Khudhair S.H.; (2014) who done studied of Evaluation Nurses' Practices, Neonatal Resuscitation in the Delivery Room,(100%) of the nurses in the study took Neonatal Resuscitation in the Delivery Room training courses in their own country. The majority (73.3 %) had attended training courses in labor and delivery care (Nuri and Ahmed, 2018). The study indicated the highest percentage is seen with more than 15 years among 52.5% of midwives while 35% have 6-11 years of experience. Nuriy and Ahmed,(2018) findings in Erbil's City Maternity Teaching Hospital. More than half of the nurse/midwives (53.3 %) had 1–9 years of experience in the labor room. Assessment of Midwives’ Practices about Immediate Care for Newborn The results of the study about the assessment of midwives’ practices showed that the total mean score of post midwives practice were (79.2%, 13.5% and 7.3%) for the done correctly, done not correctly and not done respectively. Moreover, after the training intervention, the newborn care practice was improved in different relevant areas such as; maintain dry and warm for the newborn after birth, oral suctioning, nasal suctioning and Apgar score. These results were in agreed to similar study from Ethiopia (Sintayehu,et al., 2020) who reported that a considerable proportion of the nurses and midwives had IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 46 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Rabab Omer Mohammed Salih 1 * https://ijojournals.com/ Volume 08 || Issue 03 || March, 2025 || “Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." improved newborn practices and skills. However, the improvement in our study was greater than some other studies, for example, in India (6.3%) (Devi S. 2015). This might be due to the impact of the current focus of neonatal care service in the intervention material. The results of the study indicated that (14.5%) of the midwives showed a good performance and after implementation practice program and conducting the post-test, the midwives expressed good performance (80.8%). The current study indicated that there were high significant differences (P 0.01) in midwives’ practice at pretest and posttest before and after the implementation of practice program for study sample. Whereas, the total means were (80.8%) for posttest, as for pretest (14.5%). This result was agree with (Taghreed, 2019) found that the mean percentage of posttest graduates’ practices=88% and the pretest was at the moderate levels by (23.3%).And there was a high significant correlation between pretest and posttest (before and after the implementation of an educational and practice programs for study sample (Arba. A. Zana, 2020). CONCLUSION The study concluded that the midwives' practice showing poor to fair level skills before training practice program. However, after training program they showing good level practice skills regarding immediate care of newborn. IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 47 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Rabab Omer Mohammed Salih 1 * https://ijojournals.com/ Volume 08 || Issue 03 || March, 2025 || “Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." RECOMMENDATIONS Based on the conclusion the study recommended the following:  The researcher can conducted similar training program is required for midwives in-service education.  The health care Providers should be encouraged to upgrade their training program level to build their skill retention and expose themselves to newborn care.  Further, understanding factors affecting how midwives and nurses gain and retain skills using high-level methodology are essential REFERNCES Abdu H, Gebrselassie M, Abdu M, Mare KU, Tadesse W, Liben ML.; (2019). Knowledge and practice of immediate newborn care among midwives and nurses in public health facilities of Afar regional state, Northeast Ethiopia. BMC Pregnancy Childbirth. 2019;19(1):422. Ali, S. H., &Ghafel, H. H. (2022). Nurse-Midwives’ knowledge and practices about immediate newborn care. International Journal of Health Sciences, 6(S1), 8915–8940. Retrieved from https://sciencescholar.us/journal/index.php/ijhs/article/view/7033 IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 48 https://sciencescholar.us/journal/index.php/ijhs/article/view/7033 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Rabab Omer Mohammed Salih 1 * https://ijojournals.com/ Volume 08 || Issue 03 || March, 2025 || “Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." Arba, A, Zana, Z. Knowledge of essential newborncare and associated factors among nurses and Midwives: a cross-sectional study at public healthfacilities in Wolaita Zone, Southern Ethiopia, 2019. International journal of pediatrics. 2020 : 1-8 Babeker, Z. A. (2015). Assessment of nurses knowledge and practice regarding care of premature baby in neonatal intensive care unit at Omdurman Maternity Hospital and Alribat University Hospital in pediatric nursing. Faculty of Graduate Studies and Scientific Research, The National Ribat University. Berhe A. K. ,Tinsae F. , ziabherG. G. ; (2017). Knowledge and practice of immediate newborn care among health care providers in eastern zone public health facilities, Tigray, Ethiopia, 2016, BMC Pediatr. 17 (1) (2017) 157. Devi S. (2015). A study to assess the effectiveness of Neonatal resuscitation Programme, First Golden minute certified training Course on knowledge and skill set of Nurses working in selected Hospital of Pune city. Int J Sci Res [Internet].;4(2277):432–5. Khudhair S.H.;( 2014). Evaluation Nurses' Practices Toward Neonatal Resuscitation in the Delivery Room. Assistant Instructor, Pediatric Nursing Department, College of Nursing, University of Baghdad IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 49 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Rabab Omer Mohammed Salih 1 * https://ijojournals.com/ Volume 08 || Issue 03 || March, 2025 || “Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." Koru C (2013) Newborn care practices at home and in health facilities in 4 regions of Ethiopia. BMC Pediatr 13:198 Lazzerini M, Valente EP, Covi B, et al.; (2019). Use of WHO standards to improve quality of maternal and newborn hospital care: a study collecting both mothers’ and staff perspective in a tertiary care hospital in Italy. BMJ Open Quality. 2019;8(1):e000525–e000525. doi:10.1136/bmjoq-2018- 000525 Mohammad, H. N. ;(2020). Nurse Midwives Knowledge Regarding Nursing Management of Post-Partum Hemorrhage at in Iraq. Medico Legal Update, 20(4), 1706-1712. Nuriy L.A.M. & Ahmed; H.M.; (2018). College of Nursing, Sulaimaniya University, Sulaimaniya, Iraq. Department of Midwifery, College of Nursing, Hawler Medical University, Erbil, Iraq Nurse/Midwives' practices during labor and delivery in Maternity Teaching Hospital in Erbil City https://doi.org/10.15218/ejnm.2018.04 EJNM, Vol. 1, No. (1), May, 2018Original Article Taghreed Mohammed Abu Hadaf1, Hamza Mohammed Abdeljawad, and Ayman Mustafa Abu Mustafa. (2019). The Effect of a Midwifery Educational Program on Graduates’ Knowledge, Attitudes, and Practices in Gaza Strip: IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 50 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Rabab Omer Mohammed Salih 1 * https://ijojournals.com/ Volume 08 || Issue 03 || March, 2025 || “Effect of Training Program on Midwives Practice Regarding Immediate Care of Newborn on in Governmental Hospitals Sinnar state. Sudan, 2022." Perception of Graduates. Pediatrics and Neonatal Nursing: Open Access. ISSN 2470-0983 | Open Access. Volume 4 - Issue 1. Rabab. Mohamed Adam* and ButhinaBassyonieElssayed (2022) “The Effect of Neonatal Training Programs on NICU Nurses’ Knowledge and Practice in the Military and Police Hospitals of Khartoum State, Sudan,” Sudan Journal of Medical Sciences, vol. 17, Issue no. 1, pages 28–38. Roué J-M, Kuhn P, Maestro ML, et al.; (2017). Eight principles for patientcentred and family centred care for newborns in the neonatal intensive care unit. Archives of Disease in Childhood Fetal and Neonatal Page 20/22 Edition 2017;102(4):F364-F68 Sintayehu Y, Desalew A, Geda B, Tiruye G, Mezmur H, Shiferaw K, et al. (2020) Basic neonatal resuscitation skills of midwives and nurses in Eastern Ethiopia are not well retained: An observational study. PLoS ONE 15(7): e0236194. WHO, (2019). Newborn: reducing mortality, September 2019: https://www.who.int/ news-room/fact-sheets/detail/newborns-reducingmortality. Accessed 28 Jan 2019. 3. World Health IJO JOURNALS Volume 08 | Issue 03 | March 2025 | https://ijojournals.com/index.php/hsn/index 51 Table (1): Demographic characteristics of study group n=96