Newborn Mortality and Fresh Stillbirth Rates in Tanzania After Helping Babies Breathe Training
Top Cited Papers
- 1 February 2013
- journal article
- Published by American Academy of Pediatrics (AAP) in PEDIATRICS
- Vol. 131 (2), e353-e360
- https://doi.org/10.1542/peds.2012-1795
Abstract
BACKGROUND: Early neonatal mortality has remained high and unchanged for many years in Tanzania, a resource-limited country. Helping Babies Breathe (HBB), a novel educational program using basic interventions to enhance delivery room stabilization/resuscitation, has been developed to reduce the number of these deaths. METHODS: Master trainers from the 3 major referral hospitals, 4 associated regional hospitals, and 1 district hospital were trained in the HBB program to serve as trainers for national dissemination. A before (n = 8124) and after (n = 78 500) design was used for implementation. The primary outcomes were a reduction in early neonatal deaths within 24 hours and rates of fresh stillbirths (FSB). RESULTS: Implementation was associated with a significant reduction in neonatal deaths (relative risk [RR] with training 0.53; 95% confidence interval [CI] 0.43–0.65; P ≤ .0001) and rates of FSB (RR with training 0.76; 95% CI 0.64–0.90; P = .001). The use of stimulation increased from 47% to 88% (RR 1.87; 95% CI 1.82–1.90; P ≤ .0001) and suctioning from 15% to 22% (RR 1.40; 95% CI 1.33–1.46; P ≤ .0001) whereas face mask ventilation decreased from 8.2% to 5.2% (RR 0.65; 95% CI 0.60–0.72; P ≤ .0001). CONCLUSIONS: HBB implementation was associated with a significant reduction in both early neonatal deaths within 24 hours and rates of FSB. HBB uses a basic intervention approach readily applicable at all deliveries. These findings should serve as a call to action for other resource-limited countries striving to meet Millennium Development Goal 4.This publication has 16 references indexed in Scilit:
- Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000The Lancet, 2012
- Long-term neurodevelopmental outcomes after intrauterine and neonatal insults: a systematic reviewThe Lancet, 2012
- Effect of training traditional birth attendants on neonatal mortality (Lufwanyama Neonatal Survival Project): randomised controlled studyBMJ, 2011
- Issue attention in global health: the case of newborn survivalThe Lancet, 2010
- Global, regional, and national causes of child mortality in 2008: a systematic analysisThe Lancet, 2010
- Newborn-Care Training and Perinatal Mortality in Developing CountriesThe New England Journal of Medicine, 2010
- Two million intrapartum-related stillbirths and neonatal deaths: Where, why, and what can be done?International Journal of Gynecology & Obstetrics, 2009
- Countdown to 2015 for maternal, newborn, and child survival: the 2008 report on tracking coverage of interventionsThe Lancet, 2008
- Effect of a participatory intervention with women's groups on birth outcomes in Nepal: cluster-randomised controlled trialThe Lancet, 2004
- Effect of training on the resuscitation practices of traditional birth attendantsTransactions of the Royal Society of Tropical Medicine and Hygiene, 1994