Evaluation of a Neonatal Resuscitation Curriculum in Liberia

Abstract

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.

Effectiveness of a Pediatric Emergency Medicine Curriculum in a Public Tanzanian Referral Hospital

“…Furthermore, of the pediatric curricula that have been implemented, most have only evaluated providers' self-efficacy and knowledge acquisition. [9][10][11][12] A rare few have attempted to show changes in provider behavior or patient outcomes. 13,14 In response, the African Federation for Emergency Medicine (AFEM) assembled a working group with expertise in pediatric EM (PEM) from seven American and African academic institutions to develop a comprehensive PEM curriculum for three different tiers of healthcare professionals that would be made freely available.…”

Implementation and outcomes of a comprehensive emergency care curriculum at a low-resource referral hospital in Liberia: A novel approach to application of the WHO Basic Emergency Care toolkit

“…In total, 161 healthcare workers participated in the additional BEC programming and had a mean score improvement of 15.8% (weighted average), again comparable to the findings in this study. In Tanzania specifically, additional educational supplements including clinical cases and a mobile phone app for easy reference have also been explored but did not improve performance on postcourse assessments [34,35].…”