Every year, 10 million babies require help to breathe immediately after birth. Stimulating breathing by drying and rubbing the newborn and suctioning the baby’s mouth may be all that is needed to save a life. Although such life-saving care is readily available in the United States, in many poorer countries, it may be a distant reality for newborns whose lives hang in the balance.
A new global initiative launched in June to teach these essential skills to birth attendants in developing countries should have a dramatic impact on reducing infant mortality worldwide. The Helping Babies Breathe (HBB) curriculum, an initiative of the American Academy of Pediatrics (AAP) developed in consultation with the World Health Organization and a number of other global health organizations, was introduced in Washington, DC, through a hands-on workshop for 100 participants. Ghanaian pediatricians Drs. Priscilla Naa Lomle Wobil and Fred Adomako Boateng travelled half-way across the world to attend the training, along with MCI’s Co-Director Dr. Susan M. Blaustein.
In Ghana, home of two of our Millennium Cities – Accra and Kumasi – half of infant deaths occur during delivery and within the first 24 hours, often as a result of inadequate or lack of breathing. Further, only 59% of deliveries are conducted by skilled birth attendants. Evidence indicates that simple resuscitation techniques can significantly reduce neonatal mortality, thereby furthering progress toward attaining MDG 4, reducing child mortality by two-thirds by 2015.
The new AAP HBB training encompasses skills on preparing for birth, routine care and the Golden MinuteSM, during which a baby should be breathing well or should be ventilated, with a simple bag and mask. According to Dr. Priscilla Wobil, the employment of even the simplest means to stimulate breathing — including drying and rubbing or resuscitation — can save the majority of these babies. Such life-saving care is only available for fewer than one out of four newborns. Therefore, a large number of birth attendants must acquire the basic skills and equipment to help newborns breathe.
These two topnotch Millennium Cities’ pediatricians have been designated AAP “Master Trainers” as part of a Johnson & Johnson-backed joint project with MCI and AAP to support neonatal survival. Both doctors were pleased that the HBB training was designed to train the non-professionals, midwives and community nurses who most often deliver the babies. The doctors believe this training will be extremely useful both within the city, at the city’s periphery and beyond.
Dr. Priscilla Wobil noted that Ghana’s own Ministry of Health has long been encouraging facility deliveries, and since 2007/8 the Government has been providing free pregnancy and delivery services, as well as infant care for the first three months of life. However, because 49% of mothers still choose to deliver at home (Ghana Demographic Health Survey 2008), it is important, as AAP has already recognized, to train those birth attendants and laypeople who can help the many women continuing to give birth out in the communities.
Since the training, Drs. Wobil and Adomako Boateng have returned to Ghana and will now be working with the Ministry of Health and the Ghana Health Service to set up a pilot training, in order to assess its utility and hopefully gain government approval for the program. They will also be planning the curriculum for the Johnson & Johnson-backed neonatal survival training, which will incorporate HBB techniques into an existing newborn care package developed by Save the Children, which has been used in many countries, including Ghana. Johnson & Johnson products and a pamphlet on newborn care will be given out to the community nurses, midwives and the mothers who come in for check-ups, as an integral part of the curriculum and a celebration of the new “Ministry of Health-blessed” education component to newborn care.
For Ghana, and the other 62 countries which will receive the HBB training as part of their efforts to hasten the attainment of MDG 4, the possibility is well within reach that hundreds of thousands of newborn lives can now be saved.