Newborn mortality and fresh stillbirth rates in Tanzania after helping babies breathe training

Georgina Msemo, Augustine Massawe, Donan Mmbando, Neema Rusibamayila, Karim Manji, Hussein Lesio Kidanto, Damas Mwizamuholy, Prisca Ringia, Hege Langli Ersdal, Jeffrey Perlman

Research output: Contribution to journalArticlepeer-review

292 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)e353-e360
JournalPediatrics
Volume131
Issue number2
DOIs
Publication statusPublished - Feb 2013
Externally publishedYes

Keywords

  • Birth asphyxia
  • Fresh stillbirths
  • Helping Babies Breathe
  • Neonatal mortality
  • Premature infants

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