Improving Global Newborn Survival: Building upon &lt;b&gt;&lt;i&gt;Helping Babies Breathe&lt;/i&gt;&lt;/b&gt;

Niermeyer, Susan

doi:10.1159/000507025

Cited by 12 publications

(9 citation statements)

References 29 publications

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“…Multiple studies, including two systematic reviews, have documented HBB as an effective tool for reducing newborn morbidity and mortality, and reducing stillbirths [8][9][10][11][12]. The dissemination of improved resuscitation techniques using HBB has been supported by multiple child health partners in Nepal.…”

Section: Program Designmentioning

confidence: 99%

Newborn Resuscitation Scale Up and Retention Program Associated with Improved Neonatal Outcomes in Western Nepal

Pratap¹,

Ranjan²,

Emily³

et al. 2022

Int J Pediatr Res

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Background:The adoption of the Helping Babies Breath (HBB) tool has improved the outcomes of neonatal resuscitation following intrapartum events. Perinatal asphyxia however remains a leading cause of neonatal morbidity and mortality in Nepal. HBB training has proven effective, but a major challenge is maintaining resuscitation skills over time. Safa Sanaulo Nepal (SSN) designed an evidence-based strategy for scaling up training and sustaining long-term retention. This paper describes the implementation of SSN's model, and changes in newborn outcomes that occurred during the program. Methods and findings:The skills retention strategy relied on facility-based trainers to scale up and maintain resuscitation skills in 18 facilities in the area of Nepalgunj, Nepal. A single external mentor coached and assisted the facilitybased trainers, provided general support, and monitored progress. Prospective outcome monitoring tracked changes in health metrics for a period of 24 months (March 2018 to March 2020). During this time, 46 facility-based trainers taught resuscitation skills to 1,785 midwives, nurses, and physicians, and supported skill retention with limited data gathered on neonatal health outcomes of 49,809 vaginal deliveries and 12,823 Caesarean sections. To analyze changes over the time SSN's program was implemented, a comparison of beginning (first three months of assessment) and follow-up (last three months) rates of neonatal mortality, morbidity, and stillbirths was conducted. The total number of births assessed in this comparison was 15,947.Results indicate mortality dropped 60% (p = 0.01), morbidity dropped 77% (p = 0.01), and intrapartum stillbirths dropped 73% (p = 0.001) from beginning to follow-up.Conclusions: SSN's model provides a valuable example of how an evidence-based program focusing on facilitybased trainers, who are mentored and supported to scaleup and sustain resuscitation skills over time, may have a substantial influence on critical neonatal outcomes. This program demonstrated that capacity building required minimal external support and expense, with a single mentor mentoring, supporting, and monitoring 18 facilities. Future programs working to reduce neonatal mortality, morbidity, and intrapartum stillbirths may incorporate program elements to further improve neonatal outcomes.

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Section: Program Designmentioning

confidence: 99%

Newborn Resuscitation Scale Up and Retention Program Associated with Improved Neonatal Outcomes in Western Nepal

Pratap¹,

Ranjan²,

Emily³

et al. 2022

Int J Pediatr Res

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“…Hypoxic-ischemic encephalopathy is hereby characterized by both clinical-and biomarker-based (laboratory, electro-encephalography (EEG)) evidence of acute or subacute brain injury (encephalopathy) due to the fact of intrapartum or late antepartum brain hypoxia and ischemia [2,3]. It still accounts for a relevant proportion of neonatal deaths, especially when we focus on causes of mortality in (near)term neonates [4]. Whole body hypothermia (WBH) is an effective intervention to reduce mortality, even more pronounced in low-income countries [5,6].…”

Section: Introduction: Perinatal Asphyxia Whole Body Hypothermia and Renal Impairmentmentioning

confidence: 99%

Creatinine Trends and Patterns in Neonates Undergoing Whole Body Hypothermia: A Systematic Review

et al. 2021

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Many neonates undergoing whole body hypothermia (WBH) following moderate to severe perinatal asphyxia may also suffer from renal impairment. While recent data suggest WBH-related reno-protection, differences in serum creatinine (Scr) patterns to reference patterns were not yet reported. We therefore aimed to document Scr trends and patterns in asphyxiated neonates undergoing WBH and compared these to centiles from a reference Scr data set of non-asphyxiated (near)term neonates. Using a systematic review strategy, reports on Scr trends (mean ± SD, median or interquartile range) were collected (day 1–7) in WBH cohorts and compared to centiles of an earlier reported reference cohort of non-asphyxia cases. Based on 13 papers on asphyxia + WBH cases, a pattern of postnatal Scr trends in asphyxia + WBH cases was constructed. Compared to the reference 50th centile Scr values, mean or median Scr values at birth and up to 48 h were higher in asphyxia + WBH cases with a subsequent uncertain declining trend towards, at best, high or high–normal creatinine values afterwards. Such patterns are valuable for anticipating average changes in renal drug clearance but do not yet cover the relevant inter-patient variability observed in WBH cases, as this needs pooling of individual Screa profiles, preferably beyond the first week of life.

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“…More recently, we have also become aware of many collaborative initiatives set up to improve global newborn survival and wellbeing. These initiatives include Helping Babies Breathe [6], an American Academy of Paediatrics programme to improve neonatal resuscitation in low- and middle-income countries, the Essential Newborn Care Course [7], a WHO programme that aims to ensure health workers have the skills and knowledge to provide appropriate care during the most vulnerable neonatal period, the Healthy Newborn Network [8] which is an initiative of the Saving Newborn Lives programme, a global partnership of more than 100 organizations working to improve maternal and newborn health, and the Global Newborn Society [9], the third aim of which is to energize basic, translational, and clinical research to improve outcomes for the newborn worldwide.…”

mentioning

confidence: 99%

Global Neonatal Research

Halliday¹,

Speer²

2021

Neonatology

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Improving Global Newborn Survival: Building upon <b><i>Helping Babies Breathe</i></b>

Cited by 12 publications

References 29 publications

Newborn Resuscitation Scale Up and Retention Program Associated with Improved Neonatal Outcomes in Western Nepal

Newborn Resuscitation Scale Up and Retention Program Associated with Improved Neonatal Outcomes in Western Nepal

Creatinine Trends and Patterns in Neonates Undergoing Whole Body Hypothermia: A Systematic Review

Global Neonatal Research

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