Observational studyBMJ open2019
Frequent refresher training on newborn resuscitation and potential impact on perinatal outcome over time in a rural Tanzanian hospital: an observational study.
Observational study in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Acceptability Among Healthcare Providers of In Situ, Low-Dose, High-Frequency Neonatal Resuscitation Simulation Training Using Innovative Tools: Evidence from the Safer Births Bundle of Care.Children (Basel, Switzerland) · 2025Article
- Adherence to guidelines on quality neonatal resuscitation practices among healthcare professionals in Ghana: an observational study.BMJ open · 2025Observational
- Healthcare Workers' Perceptions on the "SaferBirths Bundle of Care": A Qualitative Study.Healthcare (Basel, Switzerland) · 2023Article
- "Safer Births Bundle of Care" Implementation and Perinatal Impact at 30 Hospitals in Tanzania-Halfway Evaluation.Children (Basel, Switzerland) · 2023Article
- Utilization of a novel mobile application, "HBB Prompt", to reduce Helping Babies Breathe skills decay.PLOS global public health · 2023Article
- Adaptation of Essential Care for Every Baby educational program to improve infant outcomes in the context of Zika.BMC pediatrics · 2022Article
- Beyond research: improved perinatal care through scale-up of a Moyo fetal heart rate monitor coupled with simulation training in northern Tanzania for helping babies breathe.BMC pediatrics · 2022Article
- Neonatal Resuscitation Skill-Training Using a New Neonatal Simulator, Facilitated by Local Motivators: Two-Year Prospective Observational Study of 9000 Trainings.Children (Basel, Switzerland) · 2022Article
- Assessing the effectiveness of newborn resuscitation training and skill retention program on neonatal outcomes in Madhesh Province, Nepal.PLOS global public health · 2022Article
- A Randomised Controlled Study of Low-Dose High-Frequency In-Situ Simulation Training to Improve Newborn Resuscitation.Children (Basel, Switzerland) · 2021Article
- The impact of introducing ambulance and delivery fees in a rural hospital in Tanzania.BMC health services research · 2021Observational
- Using simulation to help healthcare professionals relaying patient information during telephone conversations.Heliyon · 2020Article
- Predictors of Helping Babies Breathe knowledge and skills among nurses in primary health settings in Dodoma region, Tanzania.BMC pregnancy and childbirth · 2020Article
- Increased perinatal survival and improved ventilation skills over a five-year period: An observational study.PloS one · 2020Observational
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesGlobally, perinatal mortality remains high, especially in sub-Saharan countries, mainly because of inadequate obstetric and newborn care. Helping Babies Breathe (HBB) resuscitation training as part of a continuous quality improvement (CQI) programme may improve outcomes. The aim of this study was to describe observed changes in perinatal survival during a 6-year period, while adjusting for relevant perinatal risk factors.
settingDelivery rooms and operating theatre in a rural referral hospital in northern-central Tanzania providing comprehensive obstetric and basic newborn care 24 hours a day. The hospital serves approximately 2 million people comprising low social-economic status.
participantsAll newborns (n=31 122) born in the hospital from February 2010 through January 2017; 4893 were born in the 1-year baseline period (February 2010 through January 2011), 26 229 in the following CQI period.
interventionsThe HBB CQI project, including frequent HBB training, was implemented from February 2011. This is a quality assessment analysis of prospectively collected observational data including patient, process and outcome measures of every delivery. Logistic regression modelling was used to construct risk-adjusted variable life adjusted display (VLAD) and cumulative sum (CUSUM) plots to monitor changes in perinatal survival (primary outcome).
resultsDuring the 6-year CQI period, the unadjusted number of extra lives saved according to the VLAD plot was 150 despite more women admitted with pregnancy and labour complications and more caesarean deliveries. After adjusting for these risk factors, the risk-adjusted VLAD plot indicated that an estimated 250 extra lives were saved. The risk-adjusted CUSUM plot confirmed a persistent and steady increase in perinatal survival.
conclusionsThe risk-adjusted statistical process control methods indicate significant improvement in perinatal survival after initiation of the HBB CQI project with continuous focus on newborn resuscitation training during the period, despite a concomitant increase in high-risk deliveries. Risk-adjusted VLAD and CUSUM are useful methods to quantify, illustrate and demonstrate persistent changes in outcome over time.
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