Helping Babies Breathe (HBB) Training, Neonatal Encephalopathy
Conditions
Keywords
HBB knowledge and skills attainment and retention, Video-debriefing, Skills, knowledge, Birth attendants
Brief summary
Helping babies breathe (HBB) is a neonatal resuscitation training program for low-resource settings to health care workers to provide prompt respiratory support to save babies at birth. Despite massive roll-out, new-born mortality reduction has stagnated over the years. Innovative teaching methods with existing technology such as video-debriefing needs to be tested to promote competence (skills and knowledge) attainment and retention.
Detailed description
In this study we will randomize both public and private delivery facilities in Lira district northern Uganda to receive either standard HBB with video-debriefing (intervention) or standard training alone (control). We hope video-debriefing will improve competence among the health workers and promote skills and knowledge retention over time, hence reduction in neonatal mortality. The result of the study may also contribute to shaping refresher training program policy in low-resource settings.
Interventions
BEHAVIORALVideo-debriefing with standard HBB training compared with standard HBB training only
We will use the AAP training curriculum for the HBB 2nd edition through out the training and course assessments pre-and post- training and during follow-up period. Both intervention arms will a 2 days training consisting of: lectures, neonatal resuscitation demonstrations using NeoNatali mannequin, and practical skills s sessions. Pre- and post-tests knowledge (MCQs) and skills (bag mask ventilation, OSCE A, & OSCE B) will be given to all participants. In the intervention arm, in addition to standard training, participants will work in teams of three (birth attendant, mother, and an assistant) to perform different HBB case scenarios. These will be filmed and used for subsequent debriefing after each case scenarios. After all participants in the intervention have had the opportunity to participate in the debriefing, then a post test is done to assess performance. Analysis is done to compare the intervention and control arms performances.
Sponsors
University of Bergen
Makerere University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Masking description
Cluster randomization was done by an independent statistician from the University of Bergen who is not part of the study. The health workers from randomised facilities were randomly assigned to two groups of 24 participants, each to be trained for two days. The participants and the assessors did not know the intervention groups which they belonged to until the day of training. During follow-up the assessors and the PI will not know which intervention arms the participants are in.
Intervention model description
The AAP HBB curriculum will be used to train participants. Lectures will be delivered by the PI (Master Trainers), followed by demonstration of HBB skills using NeoNatali Mannequin. The participants will then be divided into two groups. One group for practical sessions with master trainers and the other group video-debriefing. The video-debriefing group will have their practical sessions filmed and then the film used for debriefing feedback. First the experiences of the team performing resuscitation will be obtained then positive feedback and learning points from other learners will be given in a respectful safe environment. All participants will be encouraged to contribute in the discussion. Pre- and Post-Test knowledge and skills will be assessed will be done using MCQs, and bag mask ventilation, OSCE A and B checklists from 2nd edition AAP HBB training manual.
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* All health care workers attending to delivery and new-born care in both public and private facilities in Lira district.
Exclusion criteria
* Those who turn up for training just for daily allowances, having been sent by their facility in-charges to fill gaps such as community vaccinators, Village Health Teams (VHTs), security officers, cleaners, and laboratory technicians
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Health workers knowledge scores in percentage | 6 months | The scores from HBB multiple choice questions (MCQs) will be used. |
| Health workers skills scores in percentages | 6 months | The scores from bag mask ventilation, OSCE A and B skills sessions will be used. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Knowledge and skills retention at 1, 3 and 6 months | 6 months | The knowledge and skills scores as described above will be used to assess retention at different time points |
| Neonatal mortality at health facilities pre- and post training | 6 months | We will determine the mortality at all the birth facilities from maternity registers to determine the effect of our training on birth outcomes |
Countries
Uganda
Contacts
Primary ContactBeatrice Odongkara, MBChB, MMed, Fellowship
Backup ContactPatricia Achola, BLIS
Outcome results
None listed