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Evaluating helping babies breathe: Training for healthcare workers at hospitals in Rwanda
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
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2013 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 102, no 1, e34-e38 p.Article in journal (Refereed) Published
Abstract [en]

Aim To evaluate the educational effectiveness of the Helping Babies Breathe programme. Methods: Knowledge of trainees from two district hospitals and one tertiary referral hospital was evaluated before and after training in 2010. A postcourse practical skills evaluation was performed on a Neonatalie Newborn Simulator. Participants underwent a re-evaluation after 3months. Results: One hundred eighteen trainees completed the course. The percentages of correct answers on a written test significantly increased from 77±15% to 91±9% (p<0.01) after training. The mean score obtained on a postcourse skill evaluation was 89±9%; 64% of the trainees achieved passing scores. Retesting 3months later showed that knowledge remained at the same level, while practical skills decreased to 83±16%, and the pass rate dropped significantly to 43% (p<0.01). Conclusion: Healthcare workers who participate in a Helping Babies Breathe programme can significantly improve their knowledge. While such knowledge is retained for at least 3months, skills dropped to unsatisfactory levels in that period of time, indicating the need for retraining in the interim or the acquisition of practical experience by such healthcare workers.

Place, publisher, year, edition, pages
2013. Vol. 102, no 1, e34-e38 p.
Keyword [en]
Education, Healthcare workers, Helping Babies Breathe, Hospital, Rwanda
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-192028DOI: 10.1111/apa.12034ISI: 000312313200017OAI: oai:DiVA.org:uu-192028DiVA: diva2:594412
Available from: 2013-01-21 Created: 2013-01-15 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Child survival in Rwanda: Challenges and potential for improvement: Population- and hospital-based studies
Open this publication in new window or tab >>Child survival in Rwanda: Challenges and potential for improvement: Population- and hospital-based studies
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

After the 1994 genocide and collapse of the health system, Rwanda initiated major social and health reforms in order to reduce child mortality and health inequities in accordance with the Millennium Development Goals. The aim of this thesis was to assess trends in under-five mortality (U5M) and equity in child survival, to study social barriers for improved perinatal and neonatal survival, and to evaluate Helping Babies Breathe (HBB), a newborn resuscitation program.

In paper I we analysed trends and social inequities in child mortality 1990−2010, using data from national Demographic and Health Surveys conducted in 2000, 2005, and 2010. The following papers were based on hospital studies in the capital of Rwanda. In paper II we explored social inequities in perinatal mortality. Using a perinatal audit approach, paper III assessed factors related to the three delays, which preceded perinatal deaths, and estimates were made of potentially avoidable deaths. Paper IV evaluated knowledge and skills gained and retained by health workers after training in HBB.

Under-five mortality declined from the peak of 238 deaths per 1000 live births (95% CI 226 to 251) in 1994 to 65 deaths per 1000 live births (95% CI 61 to 70) in 2010 and concurred with decreased social gaps in child and neonatal survival between rural and urban areas and household wealth groups. Children born to women with no education still had significantly higher under-five mortality. Neonatal mortality also decreased but at a slower rate as compared to infant and U5M. Maternal rural residence or having no health insurance were linked to increased risk of perinatal death. Neither maternal education nor household wealth was associated with perinatal mortality risks. Lack of recognition of pregnancy danger signs and intrapartum-related suboptimal care were major contributors to perinatal deaths, whereof one half was estimated to be potentially avoidable. Knowledge significantly improved after training in HBB. This knowledge was sustained for at least 3 months following training whereas practical skills had declined.

These results highlight the need for strengthening coverage of lifesaving interventions giving priority to underserved groups for improved child survival at community as well as at hospital levels.  

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. 84 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1122
Keyword
Trends, social differentials, child mortality, perinatal mortality, perinatal audit, three delays model, training healthcare workers, Helping Babies Breathe, urban hospitals, Kigali, Rwanda
National Category
Medical and Health Sciences
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-259476 (URN)978-91-554-9288-5 (ISBN)
Public defence
2015-09-23, Rosensalen, Barnsjukhuset Akademiska sjukhuset, Entrance 95/96, Uppsala, 09:15 (English)
Opponent
Supervisors
Available from: 2015-09-01 Created: 2015-08-05 Last updated: 2015-10-01

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Musafili, AimableEssén, BirgittaPersson, Lars-Åke

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