Conference abstract

Helping babies breathe, second edition: strengthening the program to increase global new born survival

Pan African Medical Journal - Conference Proceedings. 2018:9(42).21 Sep 2018.
doi: 10.11604/pamj-cp.2018.9.42.769
Archived on: 21 Sep 2018
Contact the corresponding author
Keywords: Helping babies breathe, neonatal resuscitation, neonatal survival, scientific updates, quality improvement
Oral presentation

Helping babies breathe, second edition: strengthening the program to increase global new born survival

Erick Amick1,&, Beena Kamath-Rayne2, Michael Visick3, William Keenan4, Nalini Singhal5, George A. Little6, Susan Niermeyer7

1Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA, 2Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA, 3LDS Charities, Salt Lake City, Utah, USA, 4St. Louis University, Department of Pediatrics, St. Louis, Missouri, USA, 5Alberta Children’s Hospital, Calgary, Alberta, Canada, 6American Academy of Pediatrics, Department of Global Child Health and Life Support, Elk Grove Village, Illinois, USA, 7University of Colorado, Department of Pediatrics, Aurora, Colorado, USA

&Corresponding author
Erick Amick, American Academy of Pediatrics, Department of Global Child Health and Life Support, Elk Grove Village, Illinois, USA

Abstract

Introduction: helping babies breathe (HBB), a skills-based program in neonatal resuscitation for resource limited settings, including humanitarian emergencies, has been implemented in over 80 countries since 2010. HBB implementation studies in Tanzania, Kenya, Nepal and India demonstrated significant reductions in fresh stillbirth and first-day neonatal mortality when incorporating low dose, high-frequency practice and quality improvement (QI). The first 5-year revision cycle aims at increasing the program’s impact on neonatal survival by updating scientific content, improving educational efficiency and addressing implementation challenges.

Methods: a “formula for survival” provided a framework for revisions. The 2015 international liaison committee on resuscitation (ILCOR) recommendations, formed the basis for scientific updates, published literature, program reports, consensus guidelines on reprocessing equipment, solicited feedback from frontline users and survey responses informed revisions. A meeting of stakeholders in June 2015 identified key actions for successful implementation. Draft materials underwent delphi review and field testing in India and Sierra Leone.

Results: scientific revisions simplified management with meconium-stained amniotic fluid, limited suctioning and emphasized effective and continued ventilation until onset of spontaneous respirations. Frontline users (N = 102) suggested methods to build confidence/competence in resuscitation skills and further implementation guidance for program facilitators. Users identified a need for additional practice during and after the workshop and sufficient simulation equipment. The stakeholders’ meeting validated the importance of QI and data utilization to improve outcomes. Field tests refined educational approaches to self-reflection, feedback, debriefing and additional guidance for implementation of QI measures in the facility.

Conclusion: HBB 2nd edition presents current science, reinforces learning through practice, feedback and debriefing, self-reflection, fosters facilitator mentorship and QI practices. Freely downloadable materials at hbs.aap.org make 1st edition updates and all 2nd edition materials accessible to strengthen the resuscitation component of essential newborn care in health systems and humanitarian emergency settings worldwide.