Effect of a Low-Dose/High-Frequency Training on Real-Life Neonatal Resuscitation in a Low-Resource Setting

Cavicchiolo, Maria Elena; Cavallin, Francesco; Bertuola, Federica; Pizzol, Damiano; Segafredo, Giulia; Wingi, Olivier Manzungu; Dalt, Liviana Da; Putoto, Giovanni; Trevisanuto, Daniele

doi:10.1159/000490370

Cited by 18 publications

(25 citation statements)

References 19 publications

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“…In addition, there is a paucity of literature on Liberia-specific neonatal resuscitation training, and this study provides some preliminary evidence. Studies conducted in other parts of Africa with similar resource constraints also show positive results in knowledge improvement [14,15,16].…”

Section: Discussionmentioning

confidence: 96%

“…Research in learning theory suggests that a combination of testing and spaced repetition may be the most effective for learning retention and may enhance the learner’s ability to generalize their knowledge to new situations [17]. While the optimal spacing has not been established in the literature for neonatal resuscitation, Cavicchiolo et al [16] in Mozambique suggest low-dose/high-frequency training with an adapted NRP curriculum may improve initiation and time to resuscitation [16]. Further work should focus on establishing an evidence base for the optimum spacing and delivery method for neonatal resuscitation training, as sustainability will be crucial to enacting a lasting effect on the overall mortality rate in Liberia.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of a Neonatal Resuscitation Curriculum in Liberia

et al. 2019

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Neonatal mortality in Africa is among the highest in the world. In Liberia, providers face significant challenges due to lack of resources, and providers in referral centers need to be prepared to appropriately provide neonatal resuscitation. A team of American Heart Association health care providers taught a two-day neonatal resuscitation curriculum designed for low-resource settings at a regional hospital in Liberia. The goal of this study was to evaluate if the curriculum improved knowledge and comfort in participation. The curriculum included simulations and was based on the Neonatal Resuscitation Protocol (NRP). Students learned newborn airway management, quality chest compression skills, and resuscitation interventions through lectures and manikin-based simulation sessions. Seventy-five participants were trained. There was a 63% increase in knowledge scores post training (p < 0.00001). Prior cardiopulmonary resuscitation (CPR) training, age, occupation, and pre-intervention test score did not have a significant effect on post-intervention knowledge test scores. The median provider comfort score improved from a 4 to 5 (p < 0.00001). Factors such as age, sex, prior NRP education, occupation, and post-intervention test scores did not have a significant effect on the post-intervention comfort level score. A modified NRP and manikin simulation-based curriculum may be an effective way of teaching health care providers in resource-limited settings. Training of providers in limited-resource settings could potentially help decrease neonatal mortality in Liberia. Modification of protocols is sometimes necessary and an important part of providing context-specific training. The results of this study have no direct relation to decreasing neonatal mortality until proven. A general resuscitation curriculum with modified NRP training may be effective, and further work should focus on the effect of such interventions on neonatal mortality rates in the region.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Evaluation of a Neonatal Resuscitation Curriculum in Liberia

et al. 2019

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“…A systematic review of in-service training showed that targeted, repeated interventions lead to better training outcomes [39]. A recent study in Mozambique found that LDHF training on newborn resuscitation helped improve midwife performance [40], and in Tanzania a supportive intervention to HBB resulted in higher retention of newborn resuscitation skills [23]. A cluster randomized trial in Ghana found that in health facilities using an onsite, LDHF approach to training on intrapartum care, the relative risk of newborn mortality and intrapartum stillbirth significantly declined up to a year following training, leading the authors to recommend use of this training approach [41].…”

Section: Discussionmentioning

confidence: 99%

Scale-Up of Doppler to Improve Intrapartum Fetal Heart Rate Monitoring in Tanzania: A Qualitative Assessment of National and Regional/District Level Implementation Factors

Plotkin

George²,

Bundala³

et al. 2020

IJERPH

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High-quality intrapartum care, including intermittent monitoring of fetal heart rates (FHR) to detect and manage abnormalities, is recommended by WHO and the Government of Tanzania (GoT) and creates potential to save newborn lives in Tanzania. Handheld Doppler devices have been investigated in several low-resource countries as an alternative to Pinard stethoscope and are more sensitive to detecting accelerations and decelerations of the fetal heart as compared to Pinard. This study assessed perspectives of high-level Tanzanian policymakers on facilitators and barriers to scaling up use of the hand-held Doppler for assessing FHR during labor and delivery. From November 2018–August 2019, nine high-level policymakers and subject matter experts were interviewed using a semi-structured questionnaire, with theoretical domains drawn from Proctor’s implementation outcomes framework. Interviewees largely saw use of Doppler to improve intrapartum FHR monitoring as aligning with national priorities, though they noted competing demands for resources. They felt that GoT should fund Doppler, but prioritization and budgeting should be driven from district level. Recommended ways forward included learning from scale up of Helping Babies Breathe rollout, making training approaches effective, using clinical mentoring, and establishing systematic monitoring of outcomes. To be most effective, introduction of Doppler must be concurrent with improving case management practices for abnormal intrapartum FHR. WHO’s guidance on scale-up, as well as implementation science frameworks, should be considered to guide implementation and evaluation.

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“…Shaimaa Abuelnoor Ahmed Abdelghany 2 Serena Calgaro 2,3 Amir Hussein Abubacar Seni 4 Bonifacio Rodriguez Cebola 4 Giovanni Putoto 3 Daniele Trevisanuto 2…”

Section: Ack N Owled G Em Entsmentioning

confidence: 99%