Implementation of "Helping Babies Breathe": A 3-Year Experience in Tanzania.
نویسندگان
چکیده
OBJECTIVES This first-ever country-level study assesses the implementation of the Helping Babies Breathe (HBB) program in 15 of Tanzania's mainland regions by measuring coverage, adoption and retention of provider skills, acceptability among providers, and barriers and challenges to at-scale implementation. METHODS Longitudinal facility-level follow-up visits assessed provider resuscitation knowledge and skills in using objective structured clinical examinations and readiness of facilities to resuscitate newborns, in terms of birth attendants trained and essential equipment available and functional. Focus group discussions were held with providers to determine the acceptability, challenges, and barriers to implementation of the HBB program. RESULTS Immediately after HBB training, 87.1% of providers passed the objective structured clinical examination. This number dropped to 79.4% at 4 to 6 weeks and 55.8% at 4 to 6 months (P < .001). Noting this fall-off in skills, the program implemented structured on-the-job training and supportive supervisory visits, which were associated with an improvement in skill retention. At long-term follow-up, >90% of facilities had bag-mask devices available to all beds in the labor and delivery ward, and 96% were functional. Overall, providers were highly satisfied with the HBB program but thought that the 1-day training used in Tanzania was too short, so they would welcome additional training and follow-up visits to reinforce skills. CONCLUSIONS The HBB program in Tanzania has gained acceptability and shown success in equipping providers with neonatal resuscitation knowledge, skills, and supplies. However, assessing the program's impact on neonatal mortality has proven challenging.
منابع مشابه
Helping Babies Breathe implementation in Zanzibar, Tanzania.
AIM To assess the efficacy and feasibility of implementing Helping Babies Breathe, a neonatal resuscitation programme for resource-limited environments. BACKGROUND This quality improvement project focused on training midwives on Helping Babies Breathe to address high rates of neonatal mortality secondary to birth asphyxia. METHODS The convenience sample was 33 midwives in Zanzibar, Tanzania...
متن کاملCost-Effectiveness of the “Helping Babies Breathe” Program in a Missionary Hospital in Rural Tanzania
OBJECTIVE The Helping Babies Breathe" (HBB) program is an evidence-based curriculum in basic neonatal care and resuscitation, utilizing simulation-based training to educate large numbers of birth attendants in low-resource countries. We analyzed its cost-effectiveness at a faith-based Haydom Lutheran Hospital (HLH) in rural Tanzania. METHODS Data about early neonatal mortality and fresh still...
متن کاملCost analysis of large-scale implementation of the ‘Helping Babies Breathe’ newborn resuscitation-training program in Tanzania
BACKGROUND Helping Babies Breathe (HBB) has become the gold standard globally for training birth-attendants in neonatal resuscitation in low-resource settings in efforts to reduce early newborn asphyxia and mortality. The purpose of this study was to do a first-ever activity-based cost-analysis of at-scale HBB program implementation and initial follow-up in a large region of Tanzania and evalua...
متن کاملNewborn mortality and fresh stillbirth rates in Tanzania after helping babies breathe training.
BACKGROUND Early neonatal mortality has remained high and unchanged for many years in Tanzania, a resource-limited country. Helping Babies Breathe (HBB), a novel educational program using basic interventions to enhance delivery room stabilization/resuscitation, has been developed to reduce the number of these deaths. METHODS Master trainers from the 3 major referral hospitals, 4 associated re...
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ورودعنوان ژورنال:
- Pediatrics
دوره 139 5 شماره
صفحات -
تاریخ انتشار 2017