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Implementation of the Helping Babies Breathe Training Program: A Systematic Review
Sarah M Morris1, Ellie M Fratt2, Jessica Rodriguez3
1Divisions of Global Health and.
Insights
The Helping Babies Breathe (HBB) program effectively reduces newborn mortality in low-resource settings. Regular refresher training and practice are key to maintaining skills and improving outcomes.
Area of Science:
- Global Health
- Neonatal Resuscitation
- Public Health Interventions
Background:
- Helping Babies Breathe (HBB) is a vital neonatal resuscitation program aimed at decreasing newborn mortality in resource-limited environments.
- Effective implementation of HBB is crucial for improving neonatal survival rates globally.
Purpose of the Study:
- To systematically review the literature on the Helping Babies Breathe program.
- To identify challenges, knowledge gaps, and successes across all stages of HBB implementation.
- To synthesize findings on HBB's impact on provider knowledge, clinical practice, and newborn outcomes.
Main Methods:
- A comprehensive literature search was conducted across multiple databases including Medline, POPLINE, CINAHL, LILACS, African Index Medicus, Cochrane, and Index Medicus.
- Articles related to HBB in any language were included, with quality assessed using the GRADE framework.
- Data extraction focused on HBB implementation, knowledge/skill acquisition and retention, provider behavior changes, and effects on newborn outcomes.
Main Results:
- Ninety-four articles met the inclusion criteria, highlighting staff turnover and limited training time as key implementation barriers.
- HBB was found to be cost-effective in several studies, and post-training knowledge decline can be mitigated by refresher training and on-the-job practice.
- While the impact on clinical practices varied, HBB implementation showed a significant association with decreased perinatal mortality in multiple studies.
Conclusions:
- Key challenges and success factors for HBB programming at each stage were identified.
- Despite difficulties in neonatal mortality data collection, HBB is recognized for its potential to enhance neonatal outcomes in resource-limited settings.
Context:
Helping Babies Breathe (HBB) is a well-established neonatal resuscitation program designed to reduce newborn mortality in low-resource settings.
Objectives:
In this literature review, we aim to identify challenges, knowledge gaps, and successes associated with each stage of HBB programming.
Data Sources:
Databases used in the systematic search included Medline, POPLINE, Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Health Sciences Literature, African Index Medicus, Cochrane, and Index Medicus.
Study Selection:
All articles related to HBB, in any language, were included. Article quality was assessed by using the Grading of Recommendations Assessment, Development, and Evaluation framework.
Data Extraction:
Data were extracted if related to HBB, including its implementation, acquisition and retention of HBB knowledge and skills, changes in provider behavior and clinical care, or the impact on newborn outcomes.
Results:
Ninety-four articles met inclusion criteria. Barriers to HBB implementation include staff turnover and limited time or focus on training and practice. Researchers of several studies found HBB cost-effective. Posttraining decline in knowledge and skills can be prevented with low-dose high-frequency refresher trainings, on-the-job practice, or similar interventions. Impact of HBB training on provider clinical practices varies. Although not universal, researchers in multiple studies have shown a significant association of decreased perinatal mortality with HBB implementation.
Limitations:
In addition to not conducting a gray literature search, articles relating only to Essential Care for Every Baby or Essential Care for Small Babies were not included in this review.
Conclusions:
Key challenges and requirements for success associated with each stage of HBB programming were identified. Despite challenges in obtaining neonatal mortality data, the program is widely believed to improve neonatal outcomes in resource-limited settings.
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