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Helping babies breathe: assessing the effectiveness of simulation-based high-frequency recurring training in a
Kiran Mubeen1, Marina Baig2, Sadia Abbas2
1Aga Khan University School of Nursing and Midwifery (AKUSONAM), Karachi, Pakistan. kiranrattani@gmail.com.
Insights
Simulation-based high-frequency training improved Helping Babies Breathe skills for community midwives. Periodic, structured training and ongoing support are recommended to sustain these vital newborn resuscitation skills.
Area of Science:
- Neonatal Health
- Medical Education
- Public Health Interventions
Background:
- Birth asphyxia is a leading cause of neonatal deaths in Pakistan.
- Inadequate newborn resuscitation skills among birth attendants contribute to neonatal mortality globally.
- This study evaluated a Simulation-Based High-Frequency training for Helping Babies Breathe (HBB) among Community Midwives (CMWs) in Pakistan.
Purpose of the Study:
- To assess the effectiveness of Simulation-Based High-Frequency training in improving HBB knowledge and skills.
- To evaluate the impact of repeated training sessions and supportive supervision on CMWs' resuscitation abilities.
- To gather feedback on the training program from participating CMWs.
Main Methods:
- A pre-post-test interventional study design was employed with 50 Community Midwives (CMWs).
- Three one-day Helping Babies Breathe (2nd edition) training sessions were conducted over two months with ongoing practice and monitoring.
- Knowledge and Objective Structured Clinical Examination (OSCE) skills were assessed before and after each session using McNemar and Cochran's Q tests.
Main Results:
- Significant improvements in OSCE B skills were observed after each training session (p<0.05).
- Knowledge and OSCE A showed significant improvement after the first two training sessions.
- Participants reported high satisfaction with the training's organization, content, and assessment methods.
Conclusions:
- A series of HBB training sessions combined with continuous supportive supervision effectively enhances knowledge retention and resuscitation skills.
- Periodic, structured HBB training with quality monitoring and blended learning is recommended for sustained intervention.
- While direct impact on morbidity and mortality was not detected due to sample size and intervention duration, the training shows promise for improving essential newborn care skills.
Background:
Birth asphyxia is one of the significant causes of neonatal deaths in Pakistan. Poor newborn resuscitation skills of birth attendants are a major cause of neonatal mortality in low resource settings across the globe. This study aimed to evaluate the effectiveness of the Simulation-Based High-Frequency training of the Helping Babies Breathe for Community Midwives (CMW), in district Gujrat, Pakistan.
Method:
A pre-post-test interventional study design was used. The universal sampling technique was employed to recruit 50 deployed CMWs in the entire district of Gujrat. The pre-tested module and tools of Helping Babies Breathe (2nd edition) were used in the intervention. Using the High Frequency training approach, three one-day training sessions were conducted for CMWs at an interval of 2 months. During the 2 months interval, participants were monitored and supported to practice their skills at their birthing centers. Knowledge and skills were assessed before and after each session. The McNemar and Cochran's Q tests were applied for data analysis. Participants' feedback was also obtained at the end of each training, which was analyzed through descriptive statistics.
Results:
Data from 34 CMWs were analyzed as they completed all three training sessions and assessments. The results were statistically different after each training session for OSCE B (p-value < 0.05). However, for knowledge and OSCE A, significant improvement was observed after training sessions 1 and 2 only. Pairwise comparison showed that pre-assessment at training 1 was significantly different from most of the repeated measures of knowledge, OSCE A, and OSCE B. Moreover, the learners appreciated the overall training in terms of organization, content, material, assessment, and overall competency. Additionally, due to a small sample size of the CMWs, and a short time of the intervention, significant differences in morbidity and mortality outcomes could not be detected.
Conclusion:
The study concluded that a series of training and continuous supportive supervision and facilitation enhances Helping Babies Breathe (HBB) knowledge retention and skills. The study recommends, periodic, structured and precise HBB trainings, with ongoing quality monitoring activities through blended learning modalities would help sustain and scale-up the intervention.
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