scholarly journals Revisiting: “A pre-post study of a multi-country scale up of resuscitation training of facility birth attendants: does helping babies breathe training save lives?”

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sara Berkelhamer ◽  
Nalini Singhal
Keyword(s):  
Neonatal Mortality ◽  
Low Cost ◽  
Scale Up ◽  
Neonatal Resuscitation ◽  
Population Level ◽  
Helping Babies Breathe ◽  
Birth Attendants ◽  
Resuscitation Training ◽  
Facility Birth ◽  
The Impact

Abstract Background Helping Babies Breathe (HBB) is a low cost, skills-based neonatal resuscitation education program designed specifically for use in low resource settings. Studies from Tanzania, India and Nepal have demonstrated that HBB training results in decreased rates of fresh still birth and/or neonatal mortality. However, less is known regarding the impact of training on neonatal mortality at a population level. Bellad et al. utilized (BMC Pregnancy Childbirth. 2016;16 (1):222) utilized population based registries to evaluate outcomes before and after training of facility birth attendants. Their study entitled “A pre-post study of a multi-country scale up of resuscitation training of facility birth attendants: Does Helping Babies Breathe training save lives?” suggested facility based training was not associated with consistent improvements in neonatal mortality on a population level. Discussion Combining outcomes from three diverse settings may have under-estimated the impact of HBB training. We remain concerned that the modest benefits observed in the Kenyan site were lost with compiling of data. Summary The statement that HBB “was not associated with consistent improvements in mortality” may lead to the mistaken conclusion that improvements in neonatal mortality were not seen, when in fact, they were in selected cohorts. With numerous studies demonstrating potential for reduced neonatal mortality as a result of HBB training, we encourage interpretation of these findings in the context of local care.

The Role of Simulation in Health Education Globally: A Review of the Neonatal Resuscitation Program and Helping Babies Breathe

2018 ◽  
pp. 201-217
Author(s):  
Beena D. Kamath-Rayne ◽  
Michael K. Visick ◽  
Sara K. Berkelhamer
Keyword(s):  
Neonatal Mortality ◽  
Professional Education ◽  
Life Support ◽  
Teaching Strategy ◽  
Low Cost ◽  
Neonatal Resuscitation ◽  
Helping Babies Breathe ◽  
Refresher Training ◽  
Simulation Based ◽  
Neonatal Resuscitation Program

In 2010, the Neonatal Resuscitation Program became the first life support resuscitation program to formally incorporate simulation- based training with debriefing as an educational methodology. Concurrently, a simplified simulation-based neonatal resuscitation program called Helping Babies Breathe (HBB) was created, with the goal of providing low-cost, portable programming to teach basic neonatal resuscitation to birth attendants in low- and middle-income countries. Early studies evaluating the efficacy of HBB demonstrated that facility- based implementation has the potential to reduce rates of early (<24 hour) neonatal mortality and stillbirth. Subsequent investigations that have coupled HBB training with quality improvement efforts, ongoing practice, and refresher training have shown even greater effect on neonatal mortality and stillbirth rates. However, the ideal frequency of skills practice and refresher training required to retain resuscitation skills remains poorly defined. Challenges exist in defining optimal practices, as recommendations may vary by the cadre of health care professional, education level, and access to ongoing delivery room experience. While simulation-based strategies have been shown to be effective at improving educational and clinical outcomes, the use of simulation in global health settings is challenged by hurdles such as resource limitations (complex equipment, supply chain, and expense), time intensity, dependence on skilled educators, and acceptance of simulation as a teaching strategy.

scholarly journals The BabySaver: Design of a New Device for Neonatal Resuscitation at Birth with Intact Placental Circulation

Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 526
Author(s):  
James Ditai ◽  
Aisling Barry ◽  
Kathy Burgoine ◽  
Anthony K. Mbonye ◽  
Julius N. Wandabwa ◽  
...  
Keyword(s):  
Low Cost ◽  
Neonatal Resuscitation ◽  
Sub Saharan Africa ◽  
Skilled Birth Attendants ◽  
New Device ◽  
Birth Attendants ◽  
Premature Babies ◽  
Sub Saharan ◽  
The Uk ◽  
The University

The initial bedside care of premature babies with an intact cord has been shown to reduce mortality; there is evidence that resuscitation of term babies with an intact cord may also improve outcomes. This process has been facilitated by the development of bedside resuscitation surfaces. These new devices are unaffordable, however, in most of sub-Saharan Africa, where 42% of the world’s 2.4 million annual newborn deaths occur. This paper describes the rationale and design of BabySaver, an innovative low-cost mobile resuscitation unit, which was developed iteratively over five years in a collaboration between the Sanyu Africa Research Institute (SAfRI) in Uganda and the University of Liverpool in the UK. The final BabySaver design comprises two compartments; a tray to provide a firm resuscitation surface, and a base to store resuscitation equipment. The design was formed while considering contextual factors, using the views of individual women from the community served by the local hospitals, medical staff, and skilled birth attendants in both Uganda and the UK.

The primary prevention of anxiety disorders

2020 ◽  
pp. 948-960
Author(s):  
Aliza Werner-Seidler ◽  
Jennifer L. Hudson ◽  
Helen Christensen
Keyword(s):  
Anxiety Disorder ◽  
Primary Prevention ◽  
Scale Up ◽  
Population Level ◽  
Implementation Barriers ◽  
Cognitive Behavioural ◽  
Post Test ◽  
Prevention Programmes ◽  
Programme Content ◽  
The Impact

This chapter describes the nature of primary prevention of anxiety and reports on evidence for its effectiveness. The chapter first defines prevention before reporting results of a systematic review of randomized controlled trials designed to prevent anxiety. A review of existing trials and associated effect sizes suggests that prevention programmes can be effective in preventing anxiety disorder incidence and symptoms in multiple settings (schools, workplaces, community) across the lifespan. The median effect size at post-test across all studies was 0.21, and 0.25 specifically for cognitive behavioural prevention programmes. Key elements common to prevention programmes are then discussed, including a consideration of programme content and personnel delivering the intervention. Key implementation barriers are raised, together with suggestions for how these might be overcome in order to scale up and offer prevention at a population level. The chapter concludes with a consideration of the impact these programmes could have on anxiety disorder incidence.

scholarly journals Factors influencing knowledge and practice on helping babies breathe among Skilled Birth Attendants in rural areas in Lake Zone in Tanzania

2018 ◽  
Author(s):  
Cecilia B Mzurikwao ◽  
Secilia K Ng’weshemi Kapalata ◽  
Alex Ibolinga Ernest
Keyword(s):  
Rural Areas ◽  
Neonatal Resuscitation ◽  
Birth Asphyxia ◽  
Simple Random Sampling ◽  
Cross Sectional ◽  
Helping Babies Breathe ◽  
Adequate Knowledge ◽  
Labor Ward ◽  
Resuscitation Training ◽  
Knowledge And Practice

ABSTRACTBackgroundIt is estimated that 1 million babies die each year due to birth asphyxia. Globally, it is approximated that 10 million babies cannot do it by themselves and need assistance. Helping babies breathe is a key component in reducing neonatal mortality due to birth asphyxia.MethodsA cross-sectional design was used, A total of 330 respondents included in the study. Simple random sampling by lottery was used to select the 2 regions and health facilities. The participants were selected through convenient. Data were collected using standard semi-structured questionnaire. Chi-square and Binary logistic regression were used to analyse the data.ResultsOut of 330 participants, Those who working in hospital and were more likely to have adequate knowledge (AOR= 3.227, P< 0.001) and practice (AOR= 43.807, P<0.001) than those working in Health Centers; Enlored nurses were more likely to have adequate knowledge (AOR= 3.118,P<0.05) than AMO/MD;Those with 1 year and above of experience in labor ward were more likely to have adequate practice(AOR=15.418,P<0.001) than those with less than 1 year of experience in labor ward; those who attended once on neonatal resuscitation training were adequate knowledge (AOR=1.778,P<0.05) than those who had never attended. Those with Enough equipment of neonatal resuscitation had adequate practice (AOR=4.355, P<0.001) than with no enough equipment.ConclusionRegarding the findings of the current study, it was revealed that working facility, Professional/ qualification, and training was significant predictor of knowledge while working facility, experience, and equipment was significant predictor of practice. There is a need to find effective measures on how to reduce those factors which affect knowledge and practice on helping babies breathe.

scholarly journals Development and Impact of Helping Babies Breathe Educational Methodology

PEDIATRICS ◽  
2020 ◽  
Vol 146 (Supplement_2) ◽  
pp. S123-S133 ◽  
Author(s):  
Nalini Singhal ◽  
Douglas D. McMillan ◽  
Renate Savich ◽  
Dismas Matovelo ◽  
Data Santorino ◽  
...  
Keyword(s):  
Health Care ◽  
Learning Strategies ◽  
Health Care Professionals ◽  
Educational Program ◽  
Health Care Systems ◽  
Group Discussion ◽  
Neonatal Resuscitation ◽  
Educational Materials ◽  
Helping Babies Breathe ◽  
The Impact

The educational pedagogy surrounding Helping Babies Breathe (HBB) has been transformative in going beyond a curriculum focused only on basic neonatal resuscitation; indeed, it created the framework for an educational program that has served as a model for replication for other impactful programs, such as the Helping Mothers Survive and other Helping Babies Survive curricula. The tenets of HBB include incorporation of innovative learning strategies such as small group discussion, skills-based learning, simulation and debriefing, and peer-to-peer learning, all of which begin the hard work of changing behaviors that may eventually affect health care systems. Allowing for adaptation for local resources and culture, HBB has catalyzed innovation in the development of simplified, pictorial educational materials, in addition to low-tech yet realistic simulators and adjunct devices that have played an important role in empowering health care professionals in their care of newborns, thereby improving outcomes. In this review, we describe the development of HBB as an educational program, the importance of field testing and input from multiple stakeholders including frontline workers, the strategies behind the components of educational materials, and the impact of its pedagogy on learning.

scholarly journals Evaluating Neonatal Resuscitation Skills of Practicing Nurses and Midwives in Selected Hospitals in Central Uganda​

2020 ◽  
Author(s):  
Mary Namuguzi ◽  
Karen Drake ◽  
Elizabeth Namukombe Ekong ◽  
Ekaete FRANCIS Asuquo
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Neonatal Resuscitation ◽  
The State ◽  
Neonatal Mortality Rate ◽  
Successful Resuscitation ◽  
Knowledge And Skills ◽  
Helping Babies Breathe ◽  
Regulatory Policies ◽  
Nurses And Midwives

Abstract Background: Uganda has a high neonatal mortality rate (27 per 1,000 live births), with birth asphyxia as one of the major contributor. Helping babies breathe (HBB) is an evidence-based program that aims to reduce neonatal mortality in resource-limited settings. Successful resuscitation depends on nurses’ and midwives’ knowledge and skills in neonatal resuscitation, and access to functional neonatal resuscitation equipment. This study aimed to evaluate knowledge and skills retention in neonatal resuscitation after HBB training among nurses and midwives, and the state/availability of neonatal resuscitation equipment. Methods: This study used a cross sectional design. Participants were 75 nurses and midwives from two hospitals in Central Uganda. Data were collected using questionnaires and observation checklists. Ethics approval was obtained from the Uganda Christian University and the research and ethics committees of the two hospital hospitals. Results: Nurses and midwives showed a high level of knowledge (92%). However, neonatal resuscitation skills among 44 observed participants were poor, as 68.2% failed to check equipment and select the correct mask and 45.5% did not make a firm seal when applying the mask. In addition, about 72% of participants did not ventilate at a rate of 40 breaths per minute, and 18.2% failed to assess chest movement. Observation of 44 resuscitations to evaluate the state/availability of neonatal resuscitation equipment showed that 27.3% did not have a suction device, 59.1% did not have a heat source/pre-warmed towels to warm the babies, 50% did not have appropriate self-inflating bags and masks for term and preterm babies, 72.7% had no clock/watch to count heart rate and determine the length of time ventilation was required, and 36.4% did not document that resuscitation was performed. Conclusions: To address Uganda’s neonatal mortality rate, it is necessary to implement regulatory policies for neonatal resuscitation, building nurses and midwives skills for active interventions during neonatal resuscitation as well as regular refresher courses to enhance skills. Key words: helping babies breathe (HBB), neonatal resuscitation, knowledge, skills and equipment

scholarly journals Designing and evaluating a novel mobile application for Helping Babies Breathe skills retention in Uganda: comparative study protocol

2019 ◽  
Vol 3 (1) ◽  
pp. e000561 ◽  
Author(s):  
Hasan Shamsh Merali ◽  
Natalie Hoi-Man Chan ◽  
Niraj Mistry ◽  
Ryan Kealey ◽  
Douglas Campbell ◽  
...  
Keyword(s):  
Comparative Study ◽  
Mobile Application ◽  
Neonatal Resuscitation ◽  
Training Programme ◽  
Second Phase ◽  
Early Neonatal Mortality ◽  
Helping Babies Breathe ◽  
Skills Retention ◽  
District Hospitals ◽  
Resuscitation Training

IntroductionOver 600 000 newborns die each year of intrapartum-related events, many of which are preventable in the presence of skilled birth attendants. Helping Babies Breathe (HBB) is a neonatal resuscitation training programme designed for low-resource settings that can reduce both early neonatal mortality and stillbirths. However, as in other similar educational programmes, knowledge and skill retention deteriorate over time. This trend may be counteracted by strategies such as regular simulated exercises. In this study, a mobile application (app) ‘HBB Prompt’ will be developed to assist providers in retaining HBB knowledge and skills.Methods and analysisThis is a comparative study in Uganda with two phases: an app development phase and an assessment phase. In the first phase, HBB trainers and providers will explore barriers and facilitators to enhance learning and maintenance of HBB skills and knowledge through focus group discussions (FGDs). The FGDs are designed with a human factors perspective, enabling collection of relevant data for the prototype version of HBB Prompt. The app will then undergo usability and feasibility testing through FGDs and simulations. In the second phase, a minimum of 10 healthcare workers from two district hospitals will receive HBB training. Only the intervention hospital will have access to HBB Prompt. All participants will be asked to practise HBB skills every shift and record this in a logbook. In the intervention site, app usage data will also be collected. The primary outcome will be comparing skills retention 12 months after training, as determined by Objective Structured Clinical Examination B scores.Ethics and disseminationThis study received ethics approval from The Hospital for Sick Children and Mbarara University of Science and Technology. The authors plan to publish all relevant findings from this study in peer-reviewed journals.Trial registration numberNCT03577054

scholarly journals Strategies to sustain a quality improvement initiative in neonatal resuscitation

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Carlien Van Heerden ◽  
Carin Maree ◽  
Elsie S. Janse van Rensburg
Keyword(s):  
Quality Improvement ◽  
Neonatal Mortality ◽  
District Hospital ◽  
Neonatal Resuscitation ◽  
World Health ◽  
Quality Improvement Initiative ◽  
Neonatal Deaths ◽  
Early Neonatal Mortality ◽  
District Hospitals ◽  
Resuscitation Training

Background: Many neonatal deaths can be prevented globally through effective resuscitation. South Africa (SA) committed towards attaining the Millennium Development Goal 4 (MDG4) set by the World Health Organization (WHO). However, SA’s district hospitals have the highest early neonatal mortality rates. Modifiable and avoidable causes associated with patient-related, administrative and health care provider factors contribute to neonatal mortality. A quality improvement initiative in neonatal resuscitation could contribute towards decreasing neonatal mortality, thereby contributing towards the attainment of the MDG4.Aim: The aim of this study was, (1) to explore and describe the existing situation regarding neonatal resuscitation in a district hospital, (2) to develop strategies to sustain a neonatal resuscitation quality improvement initiative and (3) to decrease neonatal mortality. Changes that occurred and the sustainability of strategies were evaluated.Setting: A maternity section of a district hospital in South Africa.Methods: The National Health Service (NHS) Sustainability Model formed the theoretical framework for the study. The Problem Resolving Action Research model was applied and the study was conducted in three cycles. Purposive sampling was used for the quantitative and qualitative aspects of data collection. Data was analysed accordingly.Results: The findings indicated that the strategies formulated and implemented to address factors related to neonatal resuscitation (training, equipment and stock, staff shortages, staff attitude, neonatal transport and protocols) had probable sustainability and contributed towards a reduction in neonatal mortality in the setting.Conclusion: These strategies had the probability of sustainability and could potentially improve neonatal outcomes and reduce neonatal mortality to contribute toward South Africa’s drive to attain the MDG4.

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