6 September 2012

This is for the mothers, providing life that may otherwise be lost. Sharing the occasion of new life with a mother is very joyful. You can’t equate that feeling to anything. — Dr. Jonathan Musonda, pediatric anesthesiologist and new Helping Babies Breathe trainer

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Dr. Jonathan Musonda has always been passionate about the lives of mothers and their newborns. As a pediatric anesthesiologist at Ndola Central Hospital, Dr. Musonda has spent more than a decade in the Copperbelt Region of Zambia, using his skills as an emergency obstetric and newborn care (EmONC) provider and trainer to administer anesthesia and intubate babies who are unable to breathe on their own, as well as to train fellow colleagues in EmONC.

Despite his extensive training and skills, Dr. Musonda has found it quite challenging to optimally perform his role as an EmONC provider. Ndola Central Hospital is considered a tertiary health facility, meaning that it receives referrals for patients, including pregnant and delivering women, who require intensive medical care. Despite this, essential equipment—such as tracheal tubes and ventilators—are often lacking at the hospital, severely hindering health workers’ ability to provide much-needed interventions. It is not unusual for providers to manually ventilate babies for several hours at a time; however, if staffing is short and client loads are high, newborns may be left to die. Dr. Musonda is determined not to let this practice continue.

Earlier this year, Dr. Musonda was one of 16 participants invited to attend a Helping Babies Breathe (HBB) Training of Trainers, a three-day workshop conducted by MCHIP in collaboration with the Zambia Ministry of Health (MOH) under the USG-sponsored Saving Mothers, Giving Life (SMGL) endeavor. The workshop participants were EmONC providers and trainers from the four SMGL target districts: Kalomo, Lundazi, Mansa and Nyimba. Through this training, they were equipped with the knowledge and skills to train and mentor their colleagues in neonatal resuscitation, using the HBB curriculum.

[Below: MCHIP technical advisor Martha Ndhlovu and the newly trained Dr. Musonda with the HBB action plan.]



While neonatal resuscitation has long been a component of EmONC training in Zambia, HBB utilizes an innovative, simplified approach specifically designed for low-resource settings, such as those in which Dr. Musonda and his colleagues work. Focusing on the first “golden minute” of life, HBB centers around simple interventions—such as drying and warmth, clearing the airway, and bag and mask ventilation—which for 99% of babies will be all that is required to initiate breathing. Provider skills are developed through simulations on life-like anatomic models and through use of a color-coded action plans to guide clinical decision-making. With these new skills learned, the newly trained trainers developed district action plans in preparation for training their colleagues in rural hospitals and health centers in these lifesaving techniques.

Dr. Musonda foresees the impact of this training. Remarking on the way it effectively addressed the challenges that he has observed in his hospital, Dr. Musonda said: “This program will change the way we resuscitate newborns. Perhaps we can see a positive shift if we are able to pass on this information. If so, then there will be glorious outcomes with this new method.”