Community-based newborn resuscitation among frontline providers in a low-resource country

Autor: Kristian R. Olson, Melva Sihombing, Anthony J. Guarino, Aya Caldwell, Brett D. Nelson
Rok vydání: 2012
Předmět:
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 119(3)
ISSN: 1879-3479
Popis: 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 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.
Databáze: OpenAIRE