Authors

  1. Callister, Lynn Clark PhD, RN, FAAN

Article Content

Building on the Millennium Development Goals, the Sustainable Development Goals include a global emphasis on "attaining healthy life for all at all ages" (http://www.un.org/sustainabledevelopment/sustainable-development-goals/). A Call to Action Summit 2015 held in India in August 2015 that focused on preventable maternal/child deaths served as a prelude to the United Nations Summit in September 2015 on the adoption of the post-2015 Development Agenda.

 

Vulnerable populations globally are the unborn and the newly born, especially in low resource areas. It is estimated that half of three million newborn deaths globally each year occur during birth or within the first 24 hours of life. Six million newborns require assistance with breathing immediately after birth (Bang et al., 2014).

 

A remarkable evidence-based intervention with documented significant outcomes is Helping Babies Breathe (HBB), a neonatal resuscitation program embedded within essential services for mothers and newborns (http://www.healthynewbornnetwork.org/partner/helping-babies-breathe). This American Academy of Pediatrics initiative partners with the World Health Organization, United States Agency for International Development, Save the Children's Saving Newborn Lives program, the National Institute of Child Health and Development, and other global health stakeholders such as Latter-day Saint (LDS) Charities and Laerdal Global Health.

 

The critical goal of this initiative is taking advantage during the Golden Moment, or the first minute following birth, to reduce newborn asphyxia. The focus is on the essential interventions of drying, warmth, clearing the airway, stimulation to breathe, and bag and mask ventilation if necessary. Helping Babies Breathe is much more than a classroom educational experience. It extends to changing healthcare systems in low resource environments.

 

For example, LDS Charities, sponsored by the Church of Jesus Christ of Latter-day Saints, sends volunteer physicians and nurses to countries such as Indonesia to educate local healthcare providers including midwives in rural settings, who in turn train their local colleagues. This innovative "trainer to trainer" program was implemented in over 40 sites around the world in 2014. In-country, LDS Charities partners with local organizations that have demonstrated strength. In Indonesia, LDS Charities has partnered for nearly 10 years with Perinasia, an organization of neonatologists, obstetricians, and pediatricians (now extended to midwives) with an impressive history of neonatal resuscitation training. The charity provides a professional team of educators and equipment. A resuscitator is provided to clinics, and in remote areas where there is no clinic, a resuscitator is given to midwives for use in home births. Midwives completing the training receive their own personal suction device and stethoscope. An $80 donation to LDS Charities supplies two of these much needed and valued kits to midwives, with 100% of the contributions funding Maternal and Newborn Care initiatives. If one out of 60 midwives educated is able to successfully resuscitate only two newborns during her career because of HBB, the cost is only $54 per newborn (http://www.ldscharities.org).

 

Impressive outcomes from HBB since 2009 in Tanzania and India have been documented (Goudar et al., 2013; Msemo et al., 2013). There has been a remarkable 47% reduction in early neonatal mortality (7 days postpartum) and a significant reduction in "fresh" stillbirths in Tanzania. Goudar et al.'s work documented that provider knowledge and skills were improved with HBB training, with a significant decline in stillbirths and resuscitated infants survived the neonatal period. Bang et al. (2014) described a proposed 2-year prospective pre-post study evaluating HBB and essential newborn care among the Global Network's Maternal Neonatal Health Registry, so we can look forward to those findings, including lessons learned and best practices, to ensure stillbirths and neonatal mortality continues to be reduced in low resource settings. The HBB program is making an impressive difference for vulnerable unborn and newly born babies.

 

References

 

Bang A., Bellad R., Gisore P., Hibberd P., Patel A., Goudar S., ..., Wright L. L. (2014). Implementation and evaluation of the Helping Babies Breathe curriculum in three resource limited settings: Does Helping Babies Breathe save lives? A study protocol. BMC Pregnancy and Childbirth, 14, 116. doi:10.1186/1471-2393-14-116 [Context Link]

 

Goudar S. S., Somannavar M. S., Clark R., Lockyer J. M., Revankar A. P., Fidler H. M., ..., Singhal N. (2013). Stillbirth and newborn mortality in India after helping babies breathe training. Pediatrics, 131(2), e344-e352. doi:10.1542/peds.2012-2112 [Context Link]

 

Msemo G., Massawe A., Mmbando D., Rusibamayila N., Manji K., Kidanto H. L., ..., Perlman J. (2013). Newborn mortality and fresh stillbirth rates in Tanzania after helping babies breathe training. Pediatrics, 131(2), e353-e360. doi:10.1542/peds.2012-1795 [Context Link]