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Community‐based newborn resuscitation among frontline providers in a low‐resource country
Author(s) -
Olson Kristian R.,
Caldwell Aya,
Sihombing Melva,
Guarino Anthony J.,
Nelson Brett D.
Publication year - 2012
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2012.07.012
Subject(s) - medicine , confidence interval , cohort , asphyxia , resuscitation , intervention (counseling) , neonatal resuscitation , positive pressure ventilation , emergency medicine , cohort study , obstetrics , nursing , respiratory failure , anesthesia
Objective To evaluate a birth asphyxia management program among community midwives in a low‐resource rural setting. Methods Concise training with provision of positive‐pressure ventilation devices was implemented in Indonesia in 2005. The effectiveness of the intervention among community‐based midwives between October 2007 and September 2008 was evaluated. The intervention cohort was compared with a neighboring control cohort. Results Overall, 242 intervention and 106 control midwives were surveyed. In total, 3116 births were attended, 84.0% of deliveries occurred at home, and 97.4% of midwives had not previously owned a resuscitation device. When positive‐pressure ventilation was administered, newborn survival on day 1 was equivalent in the 2 cohorts (88.4% versus 84.4%; P = 0.66). However, significantly more newborns in the intervention group underwent ventilation (risk ratio 2.3; 95% confidence interval, 1.4–8.0). The intervention group had significantly greater scores on both knowledge ( t [144.35] = 10.52; P < 0.001) and confidence ( t [134.17] = 11.66; P < 0.001). Conclusion Focused community‐based resuscitation training and device delivery resulted in a significantly increased proportion of newborns receiving life‐saving positive‐pressure breaths, in addition to improved provider knowledge and confidence. Furthermore, the program demonstrated the establishment of an effective training infrastructure within a disrupted health system.