Assessment of Nurses’ Competence in Neonatal Assessment and Management at Secondary Health Facilities in Kogi State

Background: Midwives and nurses at secondary health facilities play a pivotal role in newborn survival through timely neonatal assessment and management, particularly in states with limited tertiary hospital access. Aim: This study assessed nurses' competence in neonatal assessment and management at secondary health facilities in Kogi State, North Central Nigeria. Methods: A descriptive cross-sectional design recruited 65 midwives and nurses through stratified random sampling from four general hospitals. A validated neonatal competence assessment tool and clinical observation checklist were used. Data were analysed using SPSS version 25. Results: Adequate competence in APGAR scoring and initial newborn stabilisation was demonstrated by 68% of participants. However, competence in recognition of neonatal danger signs and management of low birth weight infants was adequate in only 43% and 37% respectively. Facility-level training and prior Helping Babies Breathe certification were significant competence predictors. Conclusion: Neonatal nursing competence gaps at secondary facilities in Kogi State increase the risk of preventable neonatal deaths. Structured neonatal nursing training, newborn care kits, and regular competence assessments are recommended to improve neonatal survival outcomes. Keywords: neonatal assessment, nursing competence, Kogi State, secondary health, newborn care.