Helping Babies Survive Training Programs: Evaluating a Teaching Cascade in Ethiopia.

Area of Science:

• Global Health
• Medical Education
• Neonatal Care

Background:

• Neonatal mortality remains high, particularly in low- and middle-income countries (LMICs).
• Helping Babies Survive (HBS) programs utilize a train-the-trainer cascade model for neonatal resuscitation education.
• Limited data exists on the dissemination extent and cost of HBS programs.

Purpose of the Study:

• To evaluate the reach and cost-effectiveness of a countrywide HBS training cascade in Ethiopia.
• To identify barriers to successful hospital-based HBS training.
• To assess knowledge and skill acquisition among trained midwives.

Main Methods:

• A survey of representatives from 169 hospitals was conducted to assess training dissemination and barriers.
• The cost of the training cascade was analyzed.
• Knowledge and skills were evaluated using multiple-choice question examinations (MCQE) and objective structured clinical evaluations (OSCE).

Main Results:

• Hospital-based training reached 132 hospitals (78%), with 1,146 midwives trained.
• Key barriers included inadequate educator preparation and logistical challenges.
• The cascade cost approximately $2,105 per facility or $197 per trainee, with demonstrated improvements in knowledge and skills.

Conclusions:

• The train-the-trainer approach is an effective and affordable method for disseminating HBS programs in LMICs.
• Facility-level training approaches require further investigation for knowledge and skill acquisition.
• This strategy holds promise for reducing neonatal mortality in resource-limited settings.