Mentoring, Training, and Empowerment to Help Babies Breathe

Kiran Mitha, MDBlog, Nursing

Helping Babies Breathe (HBB), the resuscitation program focused on saving babies in the first minutes of life, has drawn attention to newborn survival in resource-limited settings. Midwives, traditional birth attendants, nurses, physicians, and students have all learned how to give newborns their best chance at taking life’s first breath through the HBB curriculum. In pilot studies of HBB, the knowledge health workers gain through HBB has dramatically reduced newborn mortality – and since almost a million newborns don’t make it through their first day of life, the impact of these skills cannot be underemphasized.

Yet there are still many providers who have not been trained in the life-saving techniques of HBB, or who do not feel confident implementing their knowledge into practice.  Education and training are core to our work at Seed Global Health, and the central component of the Global Health Service Partnership (GHSP), a public-private partnership between Seed, the Peace Corps, PEPFAR, and our host-country partner universities in Uganda, Tanzania, Malawi, Liberia, and Swaziland. U.S. physician, nurse, and midwife educators are deployed for a service period of one year to work in classroom and clinical settings with local students and healthcare providers. And many GHSP volunteers have been requested by their local sites to focus their efforts around newborn resuscitation, and HBB more specifically. But what has been the impact of these GHSP volunteers in advancing neonatal resuscitation? And what’s needed going forward? We conducted a survey to begin assessing the current assets and needs of our GHSP partner sites with respect to this curriculum, ultimately to help devise a strategy that further strengthens our HBB efforts moving forward.

We found that our 25 GHSP partner sites housed 47 Master Trainers in HBB, and that 9 sites (36%) reported hosting an HBB training within the last year. Three of these HBB trainings had been directly organized with GHSP volunteers. Since GHSP’s launch in 2013, volunteers helped train approximately 960 individuals in HBB, including medical and nursing students, interns and residents, clinical staff, and faculty. We have also helped supply many sites with manikins, basic resuscitation equipment, and other materials to train in HBB.

About 1/3 to ½ of our sites, however, are still in need of more HBB Master Trainers and equipment. In addition, HBB follow-up studies show that skills and confidence in resuscitation wane in the weeks and months after a training session. Training by itself, is not sufficient to create sustainable change. Regular mentorship in the classroom and at the bedside can help reinforce skills learnt in trainings and allow trainees to translate skills into positive clinical outcomes.

So what’s next? Given these results, we hope to train all our incoming GHSP volunteers as Master HBB Trainers, so they can work with students and healthcare workers continually over the course of their service year to help internalize these critical skills. We also are helping specific institutions, at their request, to incorporate resuscitation training into the standard curricula for their nursing and medical students. Lastly, our goal is to empower those we have trained to become HBB champions. The “golden minute” of life – that first 60 seconds where baby must take its first breath – is essential to newborn survival. By training and inspiring others, we and our GHSP volunteers and alum can and move clinics, communities, and entire countries toward the ultimate aim of reducing neonatal mortality worldwide. Every newborn deserves the chance to survive and thrive – and Helping Babies Breathe gives health workers the skills to help babies get that important first breath of life.