Indiana University Medical Faculty at Forefront of New Global Initiative Saving Newborn Lives
“Already, 393 people in Kenya and hundreds of other birth attendants in pilot sites in India, Bangladesh, Tanzania and Pakistan have been trained by the Helping Babies Breathe program,” said Sherri Bucher, Ph.D., assistant research professor of pediatrics at the Indiana University School of Medicine. She is a program master trainer, global instructor and principal investigator of Helping Babies Breathe - Kenya site.
The design of NeoNatalie is essential for the success of the training program. Not only can NeoNatalie simulate the vital signs of a newborn infant, she does so without the use of electricity or batteries – items that may not be readily available in some areas. Depending on the community’s resources, the simulator can be filled with either air or water, replicating the weight and tone of a newborn. NeoNatalie also can be emptied and folded for easy transport.
Using the train-the-trainer approach, trainers go out into the field to reach out wherever babies are being born. From a modern hospital in Pakistan to a thatched hut in Kenya, they strive to educate enough people so that at least one trained birth attendant is present at every birth. This is an especially daunting task in Kenya, a country where nearly 60 percent of women do not give birth in a health facility and many of them give birth alone, said Dr. Bucher.
Peter Gisore, M.D., a Kenyan neonatologist and co-investigator for the Kenyan arm of the program, believes that “Helping Babies Breathe has the potential to champion and revolutionize care for the newborn in the developing world.”
According to Dr. Bucher, each year 11 million children die worldwide, 40 percent of whom are newborns. The World Health Organization estimates that approximately 10 million babies born each year do not breathe immediately and one million of those will die from birth asphyxia, the inability to breathe immediately after delivery.
To reduce this number, Helping Babies Breathe has developed a training solution with the most basic components of care in the first minute after birth, The Golden Minute. The program is directed towards those with limited resourses and little to no formal education.
The purpose of The Golden Minute is to ensure that babies are breathing well and if not are ventilated with a bag and mask in the first minute after birth. The training program enumerates the immediate steps that should be taken with culturally sensitive learning materials.
Basic newborn resuscitation includes drying the baby thoroughly, gentle stimulation by rubbing the newborn’s back, keeping the baby warm, suctioning secretions and, if the baby is still not breathing, helping the baby to breathe with a bag-and-mask ventilation device. These techniques contrast to common misconceptions including that babies can be resuscitated by throwing cold water on them or by holding them upside down and shaking them.
“Hope has been key to this program,” says Dr. Bucher. “Ten percent of babies are born not breathing or not breathing effectively and are often thought to be dead. After seeing the success of this program, people are filled with hope knowing that they can save babies lives.”
In addition to Drs. Bucher and Gisore, the Helping Babies Breathe Kenya team includes Moi University School of Medicine’s Fabian Esamai, MB ChB, Edward Liechty, M.D., co-investigator from Indiana University School of Medicine, and Olive Konana, M.D., also from the IU School of Medicine.
Helping Babies Breathe has different levels of training that depend on the community needs and each person’s qualifications. Currently there are four master trainers and 16 facilitators, who are experienced teachers and experts in neonatal resuscitation and were trained at the Riley Mother and Baby Hospital in Eldoret, Kenya. In the past year, these master trainers and facilitators have trained an additional 373 birth attendants in 16 districts throughout western Kenya.
“We are truly a collaborative team,” said Dr. Bucher. “Our success thus far is due to the fact that the sum of our parts is greater than the whole. Without even one of us, the Helping Babies Breathe program in Kenya would never have come so far, so fast.”
“I think it is a moral imperative that we help birth attendants and the families they serve,” said Dr. Bucher. “This program works. It really infuses hope and optimism; it is simple enough that people with limited resources and very little previous health care knowledge can help babies. Helping Babies Breathe is saving lives, every day.”
Helping Babies Breathe is an initiative of the American Academy of Pediatrics (AAP) in collaboration with World Health Organization (WHO), the US Agency for International Development (USAID), Saving Newborn Lives, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and numerous other organizations. The program is funded by an unrestricted educational grant from the Laerdal Foundation for Acute Medicine and support from Latter-day Saint Charities.