MCHIP provided direct technical and/or financial support to ministries of health and their implementing partners in 23 countries to train skilled birth attendants to acquire the knowledge and skills, using Helping Babies Breathe, needed to assist babies not breathing at birth to initiate breathing immediately after childbirth. In addition, MCHIP trained MNH Africa Regional Champions to advocate for and promote these MNH practices including HBB in their respective countries. Recognizing the need for the next generation of health workers to graduate from pre-service institutions with newborn resuscitation competencies ready to help babies breathe, MCHIP worked with selected countries including Ghana, Malawi, and Bangladesh to integrate HBB into various pre-service curricula.
Evidence-based Interventions to Prevent and Treat Birth Asphyxia
Through training and program support, including the use of SBM/R tools, MCHIP ensured that birth attendants hadthe requisite knowledge and skills to ensure better labor practices, including fetal monitoring during labor, and appropriate management of maternal complications such as eclampsia and abruption placentae to prevent birth asphyxia. The primary focus of the newborn team was ensuring birth attendants had the skills and equipment to successfully resuscitate babies who do not breathe at birth using the HBB learning materials and training methodology.
In-country Helping Babies Breathe (HBB) Activities
The goal for the MCHIP newborn team was to assist countries to have birth attendants skilled in newborn resuscitation and with the necessary functioning equipment at all birthing units, with the primary target being the public health facilities, to assist asphyxiated babies to breathe within the first golden minute of life. Bangladesh was one such country supported by MCHIP. With the MOH &FW in the lead, MCHIP in collaboration with UNICEF, Laerdal Medical Foundation, BSMMU, Save the Children\Saving Newborn Lives and ICDDRB, put Bangladesh on the pathway to achieve national coverage with HBB training ensuring that all service providers attending childbirth or providing care for newborn infants were trained on HBB and equipped to save asphyxiated babies.
In addition, in Latin America & the Caribbean (LAC), MCHIP led the dissemination of HBB for the region, including translation of materials into Spanish (such as the HBB implementation guide).
Key HBB activities included:
- Adapted HBB materials into the local language, Bangla, and piloted a successful study that was used as advocacy for the country to adopt and scale-up HBB. During the May 2010 dissemination workshop of the pilot project findings ,the Minister of Health authorized the adoption and scale-up of HBB, which led to the development of a MOH&FW led scale-up.
- Did cascade HBB trainings—from national HBB master trainers, to district and Upazilla level trainers, to service providers working in health facilities or community at the district level. All sub-national HBB training was supervised from the national level using a standardized checklist.
- Equipped medical colleges, all district and Upazilla hospitals, and Union Health and Family Welfare Centers (UH&FWCs) with childbirth services. Also equipped community Skilled Birth Attendants (CSBAs).
- Implemented post-training supportive supervision by MOH&FW, BSMMU and MCHIP staff from national level combined with supervision from district and upazilla officers.
- Undertook baseline and endline facility assessments with observation of childbirth services to evaluate impact of HBB training on childbirth practices, particularly newborn resuscitation.
- Disseminated the science in regional meetings of members of the LAC Neonatal Alliance, such as those of professional associations (pediatric, ob/gyn, nursing, midwifery).
- Conducted trainings of LAC regional Master Trainers during the same events with partners of the LAC Neonatal Alliance.
- Provided technical assistance to Ministry of Health and other partners for implementation at country levels.
In Bangladesh, HBB protocol was included in the Standard Operation Procedure for newborn Health Care in all primary and secondary health facilities. HBB training was completed in 45 of the country’s 64 districts and about 1,700 health facilities were equipped with resuscitation equipment (such as ambu bags and face masks for term and preterm babies, and suction devices, penguins). In addition, 443 health facilities (including Medical College and district hospitals, Upazilla Health Complexes and Maternal and Child Welfare Centers) received a complete set of HBB training materials to use for refresher training and/or skills maintenance practices. Almost 2,600 CSBAs received resuscitation equipment. HBB was integrated into the pre-service curricula for doctors, nurses, midwives, FWVs, private paramedics and CSBAs. The results from the HBB evaluation planned provided information on how the training impacted childbirth practices of the service providers.
In Colombia, HBB was integrated into the Integrated Management of Childhood Illness national program, and in 8 of the country’s 9 health regions in collaboration with USAID bilateral (Abt Associates).