INTRODUCTION Asphyxia, the failure to breathe or to sustain breathing at birth, is one of the main direct causes of neonatal death. Globally, approximately 3% to 6% of all newborns (6 million a year) require basic newborn resuscitation consisting stimulation and assisted ventilation at birth. Fewer than 1% of asphyxiated newborns require advanced resuscitation techniques such as intubation. chest compressions, and medications. There was marked reduction in child mortality (aged 0-5 years) between 1960 and 1990 largely because of child survival programs that focused on pneumonia, diarrhea, malaria, and vaccine-preventable conditions. the major causes of death after the neonatal period (first 28 days of life), but neonatal mortality remained essentially unchanged. The international community recognized that Millennium Development Goal 4, reducing the death of children aged younger than 5 by two-thirds between 1990 and 2015, was not likely to be achieved unless additional efforts were made to address the major causes of neonatal mortality: preterm birth, severe infections, and asphyxia.