scholarly journals Adapted Helping Babies Breathe approach to neonatal resuscitation in Haiti: a retrospective cohort study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Shannon Findlay ◽  
Morgan Swanson ◽  
Christian Junker ◽  
Mitchell Kinkor ◽  
Karisa K. Harland ◽  
...  
Keyword(s):  
Community Health ◽  
Neonatal Mortality ◽  
Health Workers ◽  
Neonatal Resuscitation ◽  
Neonatal Health ◽  
Low Resource Settings ◽  
Low Resource ◽  
Helping Babies Breathe ◽  
Community Health Initiative

Abstract Background Helping Babies Breathe (HBB) is an American Academy of Pediatrics neonatal resuscitation program designed to reduce neonatal mortality in low resource settings. The 2017 neonatal mortality rate in Haiti was 28 per 1000 live births and an estimated 85 % of Haitian women deliver at home. Given this, the Community Health Initiative implemented an adapted HBB (aHBB) in Haiti to evaluate neonatal mortality. Methods Community Health Workers taught an aHBB program to laypeople, which didn’t include bag-valve-mask ventilation. Follow-up after delivery assessed for maternal and neonatal mortality and health. Results Analysis included 536 births of which 84.3 % (n=452) were attended by someone trained in aHBB. The odds of neonatal mortality was not significantly different among the two groups (aOR=0.48 [0.16-1.44]). Composite outcome of neonatal health as reported by the mother (subjective morbidity and mortality) was significantly lower in aHBB attended births (aOR=0.31 [0.14-0.70]). Conclusion This analysis of the aHBB program indicates that community training to laypersons in low resource settings may reduce neonatal ill-health but not neonatal mortality. This study is likely underpowered to find a difference in neonatal mortality. Further work is needed to evaluate which components of the aHBB program are instrumental in improving neonatal health.

scholarly journals Helping Babies Breathe and its effects on intrapartum-related stillbirths and neonatal mortality in low-resource settings: a systematic review

2019 ◽  
pp. archdischild-2018-316319 ◽  
Author(s):  
Jorien M D Versantvoort ◽  
Mirjam Y Kleinhout ◽  
Henrietta D L Ockhuijsen ◽  
Kitty Bloemenkamp ◽  
Willem B de Vries ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neonatal Mortality ◽  
Data Extraction ◽  
Neonatal Resuscitation ◽  
Eligibility Criteria ◽  
Low Resource Settings ◽  
Low Resource ◽  
Helping Babies Breathe ◽  
Simulation Based ◽  
Registration Number

BackgroundAn important factor in worldwide neonatal mortality is the deficiency in neonatal resuscitation skills among trained professionals. ‘Helping Babies Breathe’ (HBB) is a simulation-based training course designed to train healthcare professionals in the initial steps of neonatal resuscitation in low-resource areas. The aim of this systematic review is to provide an overview of the available evidence regarding intrapartum-related stillbirths and neonatal mortality related to the HBB training and resuscitation method.Data sourcesCochrane, CINAHL, Embase, PubMed and Scopus.Study eligibility criteriaConducted in low-resource settings focusing on the effects of HBB on intrapartum-related stillbirths and neonatal mortality.Study appraisalIncluded studies were reviewed independently by two researchers in terms of methodological quality.Data extractionData were extracted by two independent reviewers and crosschecked by one additional reviewer.ResultsSeven studies were included in this systematic review; the selected studies included a total of 230.797 neonates. Significant decreases were found after the implementation of HBB in one of two studies describing perinatal mortality (n=25 108, rate ratio (RR) 0.75; p<0.001), four out of six studies related to intrapartum-related stillbirths (n=125.720, RR 0.31–0.76), in four out of five studies focusing on 1 day neonatal mortality (n=111.289, RR 0.37–0.67), and one out of three studies regarding 7 day neonatal mortality (n=4.390, RR 0.32). No changes were seen in late neonatal mortality after HBB training and resuscitation method.LimitationsIncluded studies in were predominantly of moderate quality, therefore no strong recommendations can be made.Conclusions and implications of key findingsDue to the heterogeneous quality of the studies, this systematic review showed moderate evidence for a decrease in intrapartum-related stillbirth and 1-day neonatal mortality rate after implementing the ‘Helping Babies Breathe’ training and resuscitation method. Further research is required to address the effects of simulation-based team training on morbidity and mortality beyond the initial neonatal period.PROSPERO registration numberCRD42018081141.

scholarly journals Enhancing the Supervision of Community Health Workers With WhatsApp Mobile Messaging: Qualitative Findings From 2 Low-Resource Settings in Kenya

2016 ◽  
Vol 4 (2) ◽  
pp. 311-325 ◽  
Author(s):  
Jade Vu Henry ◽  
Niall Winters ◽  
Alice Lakati ◽  
Martin Oliver ◽  
Anne Geniets ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Low Resource Settings ◽  
Low Resource

Trials of interventions for people with depression

2015 ◽  
Author(s):  
Neerja Chowdhary ◽  
Atif Rahman ◽  
Helena Verdeli ◽  
Vikram Patel
Keyword(s):  
Health Workers ◽  
Common Mental Disorder ◽  
Care Model ◽  
Low Resource Settings ◽  
Low Resource ◽  
Care Facilities ◽  
Evidence Based Treatments ◽  
The Common ◽  
Intervention Costs

Depression is a global health priority. Despite the evidence on burden and effective treatments, the vast majority of individuals affected by depression do not receive these treatments. Major challenges exist for implementation of evidence-based treatments, especially in LAMIC. A number of clinical trials have shown the effectiveness of treatment for depression across a range of low-resource settings and the common threads running through these trials. MANAS is one such trial conducted in Goa, India, which provided evidence that trained lay counsellors working within a collaborative-care model can reduce prevalence of common mental disorder, suicidal behaviour, psychological morbidity, and disability days among those attending public primary care facilities. Despite the additional resources required for the intervention, costs incurred over follow-up were similar across the two arms. The role that lay health workers can play in reducing the treatment gap has important implications for mental health care in low-resource settings.

scholarly journals Point-of-care diagnostics to improve maternal and neonatal health in low-resource settings

Lab on a Chip ◽  
2017 ◽  
Vol 17 (20) ◽  
pp. 3351-3387 ◽  
Author(s):  
Catherine E. Majors ◽  
Chelsey A. Smith ◽  
Mary E. Natoli ◽  
Kathryn A. Kundrod ◽  
Rebecca Richards-Kortum
Keyword(s):  
Neonatal Mortality ◽  
Point Of Care ◽  
Neonatal Health ◽  
Low Resource Settings ◽  
Low Resource ◽  
Point Of Care Diagnostics ◽  
Maternal And Neonatal Health ◽  
Diagnostic Technologies

We present diagnostic technologies available to detect the leading causes of maternal and neonatal mortality, highlighting key gaps in development.

scholarly journals Enhancing early detection of neurological and developmental disorders and provision of intervention in low-resource settings in Uttar Pradesh, India: study protocol of the G.A.N.E.S.H. programme

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037335
Author(s):  
Moreno Toldo ◽  
Swami Varishthananda ◽  
Christa Einspieler ◽  
Neeraj Tripathi ◽  
Anshu Singh ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Early Identification ◽  
Developmental Disorders ◽  
Health Workers ◽  
Uttar Pradesh ◽  
Autism Spectrum ◽  
Low Resource ◽  
Movement Assessment ◽  
General Movement

IntroductionAround 9% of India’s children under six are diagnosed with neurodevelopmental disorders. Low-resource, rural communities often lack programmes for early identification and intervention. The Prechtl General Movement Assessment (GMA) is regarded as the best clinical tool to predict cerebral palsy in infants <5 months. In addition, children with developmental delay, intellectual disabilities, late detected genetic disorders or autism spectrum disorder show abnormal general movements (GMs) during infancy. General Movement Assessment in Neonates for Early Identification and Intervention, Social Support and Health Awareness (G.A.N.E.S.H.) aims to (1) provide evidence as to whether community health workers can support the identification of infants at high-risk for neurological and developmental disorders and disabilities, (2) monitor further development in those infants and (3) initiate early and targeted intervention procedures.MethodsThis 3-year observational cohort study will comprise at least 2000 infants born across four districts of Uttar Pradesh, India. Community health workers, certified for GMA, video record and assess the infants’ GMs twice, that is, within 2 months after birth and at 3–5 months. In case of abnormal GMs and/or reduced MOSs, infants are further examined by a paediatrician and a neurologist. If necessary, early intervention strategies (treatment as usual) are introduced. After paediatric and neurodevelopmental assessments at 12–24 months, outcomes are categorised as normal or neurological/developmental disorders. Research objective (1): to relate the GMA to the outcome at 12–24 months. Research objective (2): to investigate the impact of predefined exposures. Research objective (3): to evaluate the interscorer agreement of GMA.Ethics and disseminationG.A.N.E.S.H. received ethics approval from the Indian Government Chief Medical Officers of Varanasi and Mirzapur and from the Ramakrishna Mission Home of Service in Varanasi. GMA is a worldwide used diagnostic tool, approved by the Ethics Committee of the Medical University of Graz, Austria (27-388 ex 14/15). Apart from peer-reviewed publications, we are planning to deploy G.A.N.E.S.H. in other vulnerable settings.

scholarly journals Effectiveness of App-Based Cognitive Screening for Dementia by Lay Health Workers in Low Resource Settings. A Validation and Feasibility Study in Rural Tanzania

2020 ◽  
pp. 089198872095710
Author(s):  
Stella-Maria Paddick ◽  
Marcella Yoseph ◽  
William K. Gray ◽  
Damas Andrea ◽  
Robyn Barber ◽  
...  
Keyword(s):  
Health Workers ◽  
Geriatric Medicine ◽  
Screening Tools ◽  
Sub Saharan Africa ◽  
Low Resource Settings ◽  
Low Resource ◽  
Dsm 5 ◽  
Dementia Screening ◽  
Rural Tanzania ◽  
Cognitive Screen

Background: The majority of people with dementia live in low-and middle-income countries (LMICs). In sub-Saharan Africa (SSA) human-resource shortages in mental health and geriatric medicine are well recognized. Use of technological solutions may improve access to diagnosis. We aimed to assess the diagnostic accuracy of a brief dementia screening mobile application (app) for non-specialist workers in rural Tanzania against blinded gold-standard diagnosis of DSM-5 dementia. The app includes 2 previously-validated culturally appropriate low-literacy screening tools for cognitive (IDEA cognitive screen) and functional impairment (abbreviated IDEA-IADL questionnaire). Methods: This was a 2-stage community-based door-to-door study. In Stage1, rural primary health workers approached all individuals aged ≥60 years for app-based dementia screening in 12 villages in Hai district, Kilimanjaro Tanzania. In Stage 2, a stratified sub-sample were clinically-assessed for dementia blind to app screening score. Assessment included clinical history, neurological and bedside cognitive assessment and collateral history. Results: 3011 (of 3122 eligible) older people consented to screening. Of these, 610 were evaluated in Stage 2. For the IDEA cognitive screen, the area under the receiver operating characteristic (AUROC) curve was 0.79 (95% CI 0.74-0.83) for DSM-5 dementia diagnosis (sensitivity 84.8%, specificity 58.4%). For those 358 (44%) completing the full app, AUROC was 0.78 for combined cognitive and informant-reported functional assessment. Conclusions: The pilot dementia screening app had good sensitivity but lacked specificity for dementia when administered by non-specialist rural community workers. This technological approach may be a promising way forward in low-resource settings, specialist onward referral may be prioritized.

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