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Neonatal resuscitation: EN-BIRTH multi-country validation study.

Ashish Kc1, Kimberly Peven2,3, Shafiqul Ameen4

  • 1International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. ashish.k.c@kbh.uu.se.

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Summary

Routine labor ward registers show potential for accurately tracking bag-mask-ventilation (BMV) coverage for newborns. However, accurately measuring the need for resuscitation remains complex, highlighting the need for further research and improved data collection systems.

Keywords:
BirthCoverageHealth management information systemsHospital recordsMeasurementNeonatal resuscitationQualitySurveyValidity

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Area of Science:

  • Neonatal resuscitation
  • Global health
  • Health informatics

Background:

  • Annually, 14 million newborns need breathing stimulation and 6 million require bag-mask-ventilation (BMV).
  • Despite investments in neonatal resuscitation equipment and training, consistent coverage tracking is lacking.
  • Accurate measurement is essential for improving neonatal outcomes.

Purpose of the Study:

  • To evaluate the accuracy of survey-reported and register-recorded data for neonatal resuscitation coverage.
  • To assess the feasibility of using routine data systems for tracking resuscitation.

Main Methods:

  • The EN-BIRTH study observed 22,752 births in Bangladesh, Nepal, and Tanzania.
  • Compared gold standard observed resuscitation data with survey reports and labor ward registers.
  • Analyzed accuracy using sensitivity, specificity, and absolute differences; collected qualitative data on recording barriers and enablers.

Main Results:

  • 23.4% of babies did not cry and 17.0% did not breathe in the first minute.
  • 16.2% received stimulation and 4.4% received BMV.
  • Survey data underestimated coverage; registers showed potential for BMV numerator accuracy but challenges in denominator measurement. Timeliness of BMV was poor (<1% within 1 min).

Conclusions:

  • Population-based surveys are not suitable for measuring resuscitation coverage due to low validity.
  • Routine labor ward registers can potentially capture BMV numerator data accurately.
  • Accurate denominator measurement and timely resuscitation tracking require further research and specialized studies.