Helping <scp>B</scp>abies <scp>B</scp>reathe implementation in <scp>Z</scp>anzibar, <scp>T</scp>anzania

Wilson, Gina; Masemo, Ame; Khatib, Maimuna Mohamed; Rende, Elizabeth K.; Hartman, Ann Michelle; Blood‐Siegfried, Jane

doi:10.1111/ijn.12561

Cited by 9 publications

(16 citation statements)

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“…Birth asphyxia and failure to initiate or sustain resuscitation at birth remain the main causes of neonatal deaths worldwide (9). These data are even higher in rural locations, such as in Zanzibar hospitals, where up to 60% of neonatal deaths occur (10,11). A survey study in five rural districts of southern Tanzania identified 219 neonatal deaths (12).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a Neonatal Resuscitation Training Programme for Healthcare Professionals in Zanzibar, Tanzania: A Pre-post Intervention Study

et al. 2021

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Background: Neonatal mortality rates remain high in Sub-Saharan African countries. Improving the newborn resuscitation skills of healthcare professionals is important in addressing this challenge. The aim of this study was to evaluate a neonatal resuscitation training programme delivered over a two-year period for healthcare professionals in Zanzibar, Tanzania.Methods: A pre- and post-intervention study was designed. We delivered neonatal resuscitation training over a 2-day period in 2017 and 2 days of refresher training in 2018. Knowledge was evaluated by a self-designed survey (11 items with a total score of 22) before and after the two training periods, and skills were evaluated by a skills checklist (six domains with 25 items with a total score of 50) completed by the trainers based on their observations. Statistical analysis included differences in the knowledge and skills scores before and after the training sessions and between the two periods.Results: A total of 23 healthcare professionals participated and completed both neonatal resuscitation training sessions. The knowledge mean scores before and after the training in 2017 increased from 9.60 to 13.60 (95% CI: −5.900; −2.099, p < 0.001), and in 2018, the scores increased from 10.80 to 15.44 (95% CI: −6.062; −3.217, p < 0.001). The mean knowledge scores post-training over time were 13.60 in 2017 and 15.44 in 2018 (95% CI: −3.489; 0.190, p = 0.030). The resuscitation skills performance between the two time periods increased from a mean of 32.26 (SD = 2.35) to a mean of 42.43 (SD = 1.73) (95% CI: −11.402; −8.945, p < 0.001).Conclusion: The neonatal resuscitation training programme increased the theoretical knowledge and resuscitation skills before and after the two training sessions and over time after a 9-month period. Continuous neonatal resuscitation training based on the local needs in resource-limited countries is essential to provide confidence in healthcare professionals to initiate resuscitation and to improve newborn outcomes.

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Section: Introductionmentioning

confidence: 99%

Evaluation of a Neonatal Resuscitation Training Programme for Healthcare Professionals in Zanzibar, Tanzania: A Pre-post Intervention Study

et al. 2021

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“…There are many potential influencers of these results. Trainings were led by local leaders with prior experience teaching HBB in Zanzibar [8]. All master trainers were midwives delivering babies in the facilities of interest.…”

Section: Key Resultsmentioning

confidence: 99%

“…A team with a small budget, local leadership and buy-in will likely be able to yield a positive impact on care of neonates through a similar implementation of HBB in a like environment. Other HBB implementations with similar strategy have also yielded positive results [8,12,17]. The limitations are acknowledged and will provide a framework to build on going forward.…”

Section: Discussionmentioning

confidence: 98%

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Helping Babies Breathe (2nd edition) implementation on a shoestring budget in Zanzibar, Tanzania

Wilson

Khatib

et al. 2020

matern health, neonatol and perinatol

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Background: To assess the efficacy and viability of implementing Helping Babies Breathe, a neonatal resuscitation program for resource-limited environments on a small budget in two of the largest delivery centers in Zanzibar, Tanzania. The quality improvement initiative concentrated on training midwives, who directly care for neonates at birth on Helping Babies Breathe to address high rates of neonatal mortality secondary to birth asphyxia. Methods: The convenience sample was 59 midwives working in the two delivery centers of interest in Zanzibar, Tanzania. The train-the-trainer implementation strategy with repeated measures design was used to assess knowledge and skills at three time points. Observations were completed through supportive supervision of deliveries in both facilities. A budget was kept throughout the implementation. Results: Knowledge scores and resuscitation skills significantly improved and were sustained over a 6-month period of time, Ps < .001. 130 supportive supervision observations were completed. Eighteen times (14%) a baby did not cry at birth and needed intervention. All were appropriately intervened for and survived the Golden Minute. The budget for this implementation was 9015.50 USD. Considering in-kind donations and financial support by the Zanzibar Ministry of Health the bottom line cost was much lower. Conclusion: Results indicate that participants retained knowledge and skills over time and were able to translate these skills into clinical practice. This initiative provides an alternative approach to implementing Helping Babies Breathe, relying on a small budget, local leadership and government support. Trial registration: Not applicable.

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“…Helping Mothers Survive (HMS) is a simulation-based training curriculum developed by Jhpiego in collaboration with global partners, with the goal of combating maternal mortality through the improvement of maternal care skills among local healthcare workers. Helping Mothers Survive was modeled after the Helping Babies Breathe (HBB) training program, which has been shown to improve birth attendants' neonatal resuscitation knowledge and skill levels as well as decrease infant mortality in various low-resource settings (9)(10)(11). Helping Mothers Survive is composed of four training modules focusing on PPH, pre-eclampsia/eclampsia, essential care for labor and birth, and threatened preterm birth care (12).…”

Section: Introductionmentioning

confidence: 99%

Helping Mothers Survive: Program Evaluation and Early Outcomes of Maternal Care Training in the Dominican Republic

Smith

Leader

Roa³

et al. 2021

Front. Public Health

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Introduction: In 2017, approximately 295,000 women died during and immediately following pregnancy and childbirth worldwide, with 94% of these deaths occurring in low-resource settings. The Dominican Republic (DR) exhibits one of the highest maternal mortality ratios in the region of Latin America and the Caribbean despite the fact that 99% of registered births in the country are reportedly attended by a skilled birth attendant. This paradox implies that programs to support healthcare worker knowledge and skills improvement are vital to improving maternal health outcomes in the DR. Helping Mothers Survive (HMS) is a provider training program developed by Jhpiego and global partners. The goal of HMS is to combat maternal mortality by contributing to quality improvement efforts that reinforce maternal health skills of local healthcare workers.Methods: An international, multisectoral group of stakeholders collaborated in the implementation of two HMS curricula, Bleeding After Birth (BAB) and pre-eclampsia & eclampsia (PE&E). Demographic information as well as pre- and post-training knowledge scores were recorded for each participant. Knowledge score improvement was assessed in order to support effectiveness of the program on knowledge acquisition of healthcare workers.Results: Three hundred and twenty healthcare workers participated in the HMS training workshops between October 2016–August 2020. Of the 320 participants, 132 were trained as master trainers. The majority of participants identified as attending physicians, followed by residents/interns, nurses, students, and “other.” A significant improvement in knowledge scores was observed for both the BAB and PE&E curricula, with a 21.24 and 30.25% change in average score (pre- to post-test), respectively. In response to COVID-19 pandemic restrictions, flexibility of the local team led to a PE&E virtual training pilot workshop in August 2020.Discussion/Conclusions: Simulation-based training improved the knowledge levels of healthcare workers for both HMS curricula. These results suggest that simulation-based workshops have an impact on knowledge acquisition and skills of healthcare workers immediately following training. For the PE&E curriculum, no significant difference in knowledge acquisition was observed between in-person and virtual training sessions. The ongoing pandemic poses challenges to program implementation; however, these preliminary results provide evidence that conducting virtual workshops may be a viable alternative to in-person training.

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Helping Babies Breathe implementation in Zanzibar, Tanzania

Abstract: Results indicate that participants retained knowledge and skills and used them in clinical practice. Observations demonstrated that participants took appropriate actions when presented with a baby who was not breathing.

Cited by 9 publications

References 8 publications

Evaluation of a Neonatal Resuscitation Training Programme for Healthcare Professionals in Zanzibar, Tanzania: A Pre-post Intervention Study

Evaluation of a Neonatal Resuscitation Training Programme for Healthcare Professionals in Zanzibar, Tanzania: A Pre-post Intervention Study

Helping Babies Breathe (2nd edition) implementation on a shoestring budget in Zanzibar, Tanzania

Helping Mothers Survive: Program Evaluation and Early Outcomes of Maternal Care Training in the Dominican Republic

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