Helping Babies Breathe Collaboration project 2012 and beyond: teaching recognition of birth asphyxia and intervention to health care attendants.
Birth asphyxia in rural Kenya remains a major cause of neonatal morbidity and mortality, resulting in approximately 25% of all newborn deaths that occur in the first 28 days postnatal. Basic neonatal resuscitation techniques can help up to 99% of these babies begin to breathe after birth. Our non-profit NGO Uhai for Health ( www.uhai.org) focuses on areas of health screening and education, and, has developed relationships with existing local and regional health care partners in clinics, district and regional hospitals in Central Kenya.
During 2010, in collaboration with these partners, we screened almost 500 patients in 3 sites. We expanded to 5 sites in rural Central Kenya during May 2011 providing screening services to approximately 2000 patients . We plan to incorporate the teaching and training encompassed in the Helping Babies Breathe (HBB) neonatal resuscitation training program for the nurses, health care workers and birth attendants that participate in our events at 2-3 sites in May 2012.
We are working with partners in the Global Network for Women’s and Children’s Health Research both in the US ( Dr Sherri Bucher, Indiana University) and in Kenya (Dr. Fabian Esamai) in order to coordinate and harmonize our training efforts with those already underway with existing Helping Babies Breathe stakeholders, including the Kenya Neonatal Resuscitation Council, the Kenya Pediatric Association and the district representatives of the Ministry of Health (Ministry of Medical Services and Ministry of Public Health and Sanitation). In addition, we hope to develop a partnership with the School and Health Sciences community outreach of Kenyatta University.
Our ongoing relationships support the structure of both initial training to a core of facilitators, access to wide variety of learners (e.g., community and facility-based), as well as the ability to monitor retention of the training skills on subsequent return visits.
Helping Babies Breathe is a skills-based neonatal resuscitation course developed by the American Association of Pediatrics using evidence-based science based on the ILCOR guidelines. It is specifically aimed at training a wide variety of providers ranging from traditional birth attendants to health –center based doctors, nurses, midwives in resource-limited settings. An important feature of this program is the concept of training-the-trainer. The goal of HBB training is to enable local providers to both care for patients and to have the knowledge and equipment to train new teachers and providers. There are 3 cadres of HBB providers; Master Trainers, Facilitators (trainer cadres) and Learners (providers of HBB, but not trainers).
Although the Ministry of Health in Kenya recognizes the importance of the newborn resuscitation training and has incorporated HBB into its national pediatric resuscitation protocol as the “Airway” and “Breathing” components for both pre- and in-service training of medical providers, many health care facilities still lack equipment and trained personnel; this paucity of appropriately trained staff and neonatal resuscitation equipment is particularly acute at rural health facilities. By providing both this initial training, and assisting with provision of materials for ongoing locally-based education and training as well as skills and supplies to assist in direct patient care, Uhai for Health will continue to collaborate with our Kenya-based partners to strengthen efforts to improve infant mortality and morbidity.