Evaluating Helping Babies Breathe: training for healthcare workers at hospitals in Rwanda

Musafili, Aimable; Essén, Birgitta; Baribwira, Cyprien; Rukundo, Alphonse; Persson, Lars‐Åke

doi:10.1111/apa.12034

Cited by 76 publications

(68 citation statements)

References 21 publications

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“…The fact that there was sustainment in ‘FMV within the Golden Minute’, and in FMV skills of the VMWs from 3 to 12 months, is in contrast to the findings of Musafili et al 18 where the number of participants passing and the OSCE scores decreased 3 months post HBB training. Our positive observations may be partly related to the fact that the NeoNatalie simulator kit was made available to the VMWs for practice during their bi-weekly visits to their local medical centre.…”

Section: Discussioncontrasting

confidence: 94%

Skills retention in Sudanese village midwives 1 year following Helping Babies Breathe training

et al. 2016

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Section: Discussioncontrasting

confidence: 94%

Skills retention in Sudanese village midwives 1 year following Helping Babies Breathe training

et al. 2016

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“…Five (50.0%) of these studies showed significant performance falloff over the time period analyzed. 37,38,48,56,66 Three studies (30.0%) showed no falloff 41,43,52 ; the 2 remaining studies (20.0%), both from Ethiopia, found varying levels of retention in different groups of birth attendants, with higher levels of training associated with less falloff. 55,67 These latter 5 studies showing either no falloff or mixed results included the 4 longest running studies in our literature review, ranging from 9 months to 2 years.…”

Section: Retention Of Knowledge and Skillsmentioning

confidence: 99%

Newborn Resuscitation Training in Resource-Limited Settings: A Systematic Literature Review

et al. 2016

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CONTEXT: Birth asphyxia contributes substantially to neonatal mortality in low-and middleincome countries (LMICs). The effects of training birth attendants in neonatal resuscitation (NR) on mortality are limited by falloff of skills and knowledge over time and transference of learned skills into clinical practice.OBJECTIVE: This review examined acquisition and retention of NR knowledge and skills by birth attendants in LMICs and the effectiveness of interventions to improve them.DATA SOURCES: Medline, Cochrane, Embase, CINAHL, Bireme, and African Index Medicus databases were searched. We reviewed Web pages and reports from non-peer-reviewed (or "gray") literature sources addressing NR training in LMICs. STUDY SELECTION:Articles on acquisition and retention of NR knowledge and skills, and interventions to improve them, were limited to LMICs. RESULTS:The initial search identified 767 articles, of which 45 met all inclusion criteria. Of these, 31 articles analyzed acquisition of knowledge and skills, and 19 analyzed retention. Most studies found high acquisition rates, although birth attendants struggled to learn bag-mask ventilation. Although significant falloff of knowledge and skills occurred after training, refresher training seemed to improve retention. Results of the gray literature analysis suggest that formal, structured practice sessions improve retention. LIMITATIONS: This review did not analyze training's direct impact on mortality.CONCLUSIONS: Knowledge and skills falloff is a significant barrier to the success of NR training programs and possibly to reducing newborn mortality in LMICs. Refresher training and structured practice show significant promise. Additional research is needed to implement and assess retention improvement strategies in classroom and clinical settings.a Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; b Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts; c Harvard Medical School, Boston, Massachusetts; and d Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah Dr Reisman oversaw the literature reviews, interpreted the results, and drafted the initial manuscript; Ms Arlington assisted with the gray literature search and reviewed and revised the manuscript; Dr Jensen performed the initial gray literature analysis and reviewed and revised the manuscript; Mr Louis and Ms SuarezRebling conducted the initial literature review; and Dr Nelson conceptualized and designed the literature review and reviewed and revised the manuscript. All authors approved the fi nal manuscript as submitted.

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“…The program includes a validated simulation evaluation tool called an Objective Structured Clinical Examination (OSCE) [3,4]. Several studies have demonstrated trainee improvement on the examination using a pre-post design [5–8]. However, evidence also suggests performance decreases significantly over time when learners are not provided with ongoing refresher training [9,10].…”

Section: Introductionmentioning

confidence: 99%

Retention and use of newborn resuscitation skills following a series of helping babies breathe trainings for midwives in rural Ghana

Eblovi

Kelly

Afua

et al. 2017

Global Health Action

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Background: The Helping Babies Breathe (HBB) program teaches basic newborn resuscitation techniques to birth attendants in low-resource settings. Previous studies have demonstrated a decrease in mortality following training, mostly in large hospitals. However, low-volume clinics in rural regions with no physician immediately available likely experience a greater relative burden of newborn mortality. This study aimed to determine the impact of HBB trainings provided to rural Ghanaian midwives on their skills retention and on first 24 hour mortality of the newborns they serve. Methods: American Acadamy of Paediatrics (AAP)-trained Master Trainers conducted two 2-day HBB trainings and 2-day refresher courses one year later for 48 midwives from Ghanaian rural health clinics. Trainee skills were evaluated by Objective Structured Clinical Examination (OSCE) at three time points: immediately after training, four months after training, and four months after the refresher. Midwives recorded the single highest level of resuscitation performed on each newborn delivered for one year. Results: 48 midwives attended the two trainings, 32 recorded data from 2,383 deliveries, and 13 completed OSCE simulations at all three time points. The midwives’ OSCE scores decreased from immediately after training (94.9%) to four months later (81.2%, p < 0.00001). However, four months following the refresher course, scores improved to the same high level attained initially (92.7%, p = 0.0013). 5.0% of neonates required bag-mask ventilation and 0.71% did not survive, compared with a nationwide first 24 hour mortality estimate of 1.7%. Conclusions: The midwives’ performance on the simulation exercise indicates that an in-depth refresher course provided one year after the initial training likely slows the decay in skills that occurs after initial training. Our finding that 5.0% of newborns required bag-mask ventilation is consistent with global estimates. Our observed first 24 hour mortality rate of 0.71% is lower than nationwide estimates, indicating the training likely prevented deaths due to birth asphyxia.

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Evaluating Helping Babies Breathe: training for healthcare workers at hospitals in Rwanda

Cited by 76 publications

References 21 publications

Skills retention in Sudanese village midwives 1 year following Helping Babies Breathe training

Skills retention in Sudanese village midwives 1 year following Helping Babies Breathe training

Newborn Resuscitation Training in Resource-Limited Settings: A Systematic Literature Review

Retention and use of newborn resuscitation skills following a series of helping babies breathe trainings for midwives in rural Ghana

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