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Using quality improvement to decrease birth asphyxia rates after 'Helping Babies Breathe' training in Kenya.

Amy R L Rule1,2,3,4, Esther Maina2, David Cheruiyot2

  • 1Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Acta Paediatrica (Oslo, Norway : 1992)
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Summary
This summary is machine-generated.

Quality improvement sustained gains from Helping Babies Breathe (HBB) training, significantly reducing birth asphyxia-related mortality in Kenya. Focused interventions improved neonatal outcomes and staff retention post-program.

Keywords:
Hospital practicesNeonatal resuscitationQuality improvementSimulationSub-Saharan Africa

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Area of Science:

  • Neonatal resuscitation
  • Quality improvement in healthcare
  • Global child health

Background:

  • The Helping Babies Breathe (HBB) program reduces neonatal mortality in low-resource settings.
  • Gaps in care persist, necessitating strategies to sustain improvements in birth asphyxia outcomes.

Purpose of the Study:

  • To describe the application of quality improvement (QI) methods to sustain and advance reductions in birth asphyxia-related mortality following HBB implementation.
  • To decrease the rate of suspected hypoxic-ischaemic encephalopathy (SHIE) by 50% within six months post-HBB.

Main Methods:

  • Implementation of rapid cycles of change for interventions including staff training, retention, engagement, and improved data collection.
  • Utilized run charts to monitor SHIE rates over time and chi-square analysis for statistical comparison.
  • Reviewed over 4000 delivery records for baseline and post-intervention data analysis.

Main Results:

  • The suspected hypoxic-ischaemic encephalopathy (SHIE) rate decreased by 53% (from 14.7 to 7.1 per 1000 live births, p=0.01) ten months post-HBB.
  • Initial gains were threatened by staff transfers, but presenting data to administration led to improved staff retention.
  • Post-intervention SHIE rates remained above the goal but demonstrated narrowing control limits, indicating improved stability.

Conclusions:

  • Focused quality improvement initiatives are effective in sustaining and enhancing neonatal outcomes after HBB training.
  • Sustained improvements require ongoing monitoring, data-driven interventions, and strategies for staff retention.