Impact of education and training on neonatal resuscitation practices in 14 teaching hospitals in India

Deorari, Ashok K.; Paul, Vinod K.; Singh, Meharban; Vidyasagar, D.

doi:10.1080/02724930123814

Cited by 78 publications

(58 citation statements)

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“…36 Nine studies (20%) attempted to correlate performance on either standardized tests or actual behavior in the delivery room with changes in neonatal mortality statistics, and the results were mixed. 18,30,31,37,42,60,62,64,73 Four (44.4%) of these studies documented significant declines in neonatal mortality correlating with improvement in test scores and delivery room behavior, respectively. 30,31,42,60 Five studies (55.6%) reported no improvement in mortality despite improvement in test scores and/or delivery room behavior.…”

Section: Impact Of Theoretical Knowledge On Delivery Room Behaviors Amentioning

confidence: 99%

“…25, 36, 38, 39, 48, 49, 59, 61, 62, 71, 73 -75 Sixteen studies (35.6%) evaluated clinical behavior in the delivery room in addition to, or instead of, testing birth attendants in simulated scenarios. In 10 (62.5%) of these studies, examiners directly observed birth attendants, 18,30,31,36,43,44,59,64,65 whereas in 7 studies (43.8%), scores were based on chart review or recall by birth attendants and/or the newborn's mother. 37,43,47,50,57,60,62 One study both directly observed birth attendants and surveyed community women cared for by these attendants.…”

Section: Description Of Articlesmentioning

confidence: 99%

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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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Section: Impact Of Theoretical Knowledge On Delivery Room Behaviors Amentioning

confidence: 99%

Section: Description Of Articlesmentioning

confidence: 99%

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

et al. 2016

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“…61 Extensive efforts to train physicians in neonatal resuscitation, for example using WHO and American Academy of Pediatrics-American Heart Association Neonatal Resuscitation Program materials, are underway in many developing countries, and are showing encouraging results in influencing behavior. 62,63 Few studies, however, especially community-based studies, have assessed the risk factors, causes and sequelae of birth asphyxia in developing countries, and few have evaluated appropriate methods to train health workers and family members at the community level to recognize birth asphyxia and provide simple interventions and support.…”

Section: Immediate Newborn Carementioning

confidence: 99%

Research Priorities for the Reduction of Perinatal and Neonatal Morbidity and Mortality in Developing Country Communities

et al. 2002

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Despite global declines in under-five and infant mortality rates in recent decades, neonatal mortality rates have remained relatively unchanged.1 Mortality during the first 28 days of life now accounts for two-thirds of deaths in children less than 1 year of age, and nearly four-tenths of all deaths in children less than 5 years of age.2 -4 A recent analysis found that the loss of healthy life from newborn deaths represented 8.2% and 13.6% of the burden of disease in Sub-Saharan Africa and South Asia, respectively, or 27 and 53 million years of life lost in those two respective regions alone. 5 The analysis, however, highlighted the dearth of information available on neonatal outcomes in developing countries, particularly at the community level, and the potential for currently available figures to underestimate the magnitude of the problem. Thus, epidemiological research is needed to make available more accurate data on risk factors and causes of neonatal morbidity and mortality, and improved and validated neonatal verbal autopsy instruments are needed in order to collect accurate data.For every death during the neonatal period, it is estimated that another stillbirth has occurred; when combined with the two-thirds of neonatal deaths that occur during the first week of life, perinatal deaths nearly equal the number of deaths during the entire first year of life. 6,7 Estimates from the World Bank suggest that perinatal deaths account for approximately 7% of the global burden of disease, exceeding that due to malaria and vaccine-preventable infections combined. 8 Worldwide, 98% of all neonatal deaths occur in developing countries, most often at home, outside the formal health care system, and largely due to infections (32%), birth asphyxia and injuries (29%), and consequences of prematurity and congenital anomalies (34%).9 Infections may account for approximately half of newborn deaths at the community level.10 Low birth weight (LBW) is an overriding factor in the majority of the deaths. 1Conditions that affect the neonate, including LBW, impact not only neonatal mortality but also long-term morbidity through effects on neurological and cognitive development and associations with chronic diseases such as diabetes, cardiovascular disease and chronic lung disease.11 Thus, interventions that prevent morbidity during the neonatal period have the potential to be highly cost-effective and impact health far beyond the neonatal period.In this review, we present a conceptual framework for maternal and neonatal health care, and in this context, propose priority research activities to improve perinatal and neonatal health and survival in developing country communities. CONCEPTUAL FRAMEWORK AND CONTEXT OF NEONATAL HEALTH CARE AND RESEARCHImproving newborn health and survival depends in large measure on more effectively implementing what we already know works.Although post -neonatal and child mortality rates have declined dramatically in many developing countries in recent decades, neonatal mortality rates have remained relati...

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“…19 In ten university hospitals in India, the introduction of the Resuscitation Program reduced early neonatal mortality from 31 to 24 per 1,000 live births and the incidence of hypoxic-ischemic encephalopathy by 70%. 17 Theoretical and practical training in neonatal resuscitation also results in short term benefits for the newborn, including improvements in Apgar Scores. 20 It is within this context that the present study is situated, in attempting to find out how neonatal resuscitation training is given to students soon to qualify as physicians, pediatricians, neonatologists and nurses at public maternity As can be observed in the results, the hospitals and maternity units studied were predominantly public.…”

Section: Discussionmentioning

confidence: 99%

“…Around 6 to 10% of live births need immediate respiratory care, but, once spontaneous respiration has been established, the majority of these infants survive with no need for other life support measures. [16][17][18] According to the World Health Organization, 8 education and training in resuscitation offer the possibility of immediately applying recent scientific advances to reduce neonatal morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

Ensino da reanimação neonatal em maternidades públicas das capitais brasileiras

Almeida¹,

Guinsburg²,

Costa³

et al. 2005

J. Pediatr. (Rio J.)

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Impact of education and training on neonatal resuscitation practices in 14 teaching hospitals in India

Cited by 78 publications

References 4 publications

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

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

Research Priorities for the Reduction of Perinatal and Neonatal Morbidity and Mortality in Developing Country Communities

Ensino da reanimação neonatal em maternidades públicas das capitais brasileiras

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