Implementation of the Helping Babies Breathe Training Program: A Systematic Review

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.