Cote d’Ivoire ranks third among African countries with the highest neonatal mortality rate (38‰). Perinatal asphyxia is one of the major causes of neonatal mortality. In its severe form, it imposes an efficient neonatal resuscitation in the birth room. This can only be done when the proven competence of the staff in charge of the newborn and the availability of the appropriate equipment are met. What is the situation in the birth facilities of these two challenges for the response to the high rate of neonatal mortality in Cote d’Ivoire? Method: It is a cross-sectional study, which took place from March 28 to July 28, 2016, in three health districts of Cote d’Ivoire (Bouaké, Gagnoa, Yopougon). Public health structures offering delivery activities were selected. Based on a fact sheet, the practitioners present have been interviewed and a direct observation of the organization and equipment set up to perform neonatal resuscitation in the birth room has been done. In addition, an observation grid made it possible to evaluate the practical skills of providers in neonatal resuscitation on a newborn mannequin. The data were entered using the Epi-Info 7 software. Based on the data collected, we determined the numbers and frequencies of the responses of the target agents of the survey. Results: The membership structures included 46 first contact health facilities (FCHFs) and 4 reference hospitals (HRs). The heating system, mucus suction, oxygen, timers and self-inflating balloons were available in HR and in six, eight, four, 34 and 10 FCHFs respectively. The 253 midwives surveyed came from Bouaké (86), Gagnoa (62) and Yopougon (105). They had a seniority of at least eight years. Their knowledge for newborns’ care was acquired in initial training (75% of cases). They knew the golden minute in 95.6% of the cases. Inadequacies in the recognition of risk situations, useful equipment and in the execution of neonatal resuscitation steps were noted. Conclusion: The survival of the newborn is still very worrying in Cote d’Ivoire. An analysis of the results of this survey shows that many challenges remain not only at the structural level but also at the level of quality of care.