Newborn Health_Graft-Johnson_5.12.11

Helping Babies Breathe Implementation:Where are we?

Joseph de Graft Johnson – MCHIPCORE Group Spring meetingBaltimoreMay 12, 2011

OUTLINE

Brief reminder of the components of essential newborn care

Brief description of HBB Initiative Share information on the HBB Global

Development Alliance Recommendations for PVO/NGO

involvement in HBB implementation Share HBB contact information

Essential Newborn Care

World Health Organization divides essential newborn care into two categories:

Basic care (often equated to ENC) Special care

“Basic care” that comprises “interventions for all infants to meet their physiological needs” at birth and later

Special care – comprises interventions for a small group of newborns with conditions that require extra care

WHO 1996

Essential Newborn Care-Components

1. Cleanliness2. Thermal protection3. Early and exclusive breastfeeding4. Initiation of breathing,

resuscitation5. Eye care6. Immunization7. Management of newborn illness8. Care of the preterm and/or low

birth weight newborn

Essential Newborn Care Course

New layout French version in print

Needs in Helping Babies Breathe at Birth

8-10 %

3-6%

< 1%

Assessment at birth and routine care

Drying, warmth, clearing the airway, stimulation

Bag and mask ventilation

Chest compressions, medications

80-90%

Initiation of Breathing

Always dry the baby first and assess breathingduring the process (drying may stimulate

breathing in a non-crying baby)

If baby is crying or shows no signs of breathing difficulties - continue with essential newborn care

If baby is not crying or breathing or has breathing difficulties - need to help the baby breathe (HBB)

Helping Babies Breathe (HBB)* New Simplified Resuscitation Training:

Simple color-coded algorithm (The Golden Minute™)

(1) Drying and wrapping/skin-to-skin

(2) Assess breathing – if not breathing then,

(3) Clear airway and stimulate – if not breathing then,

(4) Ventilate until breathing (or no response after 10 – 15 min)

* Developed by American Academy of Pediatrics in collaboration with Save the Children, USAID, ACCESS, NICHD, WHO, & UNICEF

”The Golden Minute”

HBB….

Designed to be used at all levels of health

system Targets community, 1st level facilities, district

hospitals -- typically where birth attendants are alone attending deliveries (frequently without a second person to assist in resuscitation)

Tertiary hospitals – especially midwives. (Does not replace current advanced resuscitation training- cardiac compressions, intubation, drugs – Pediatricians)

Pictorial algorithm Focuses on achieving and maintaining skills

Helping Babies Breathe Learning/teaching - in pairs

Global Development Alliance to

Reduce Newborn Mortality

Helping Babies Breathe

Global Development Alliance

Objective: To reduce newborn

mortality due to asphyxia Partners

Founding members: USAID, Laerdal, American Academy of Pediatrics, NICHD, Save the Children, and USAID’s implementing partners - MCHIP, HCI, HealthTech, CORE, Africa 2010

Growing partnership: UNICEF, WHO, Latter Day Saints Church, Earth Institute

Adopted from Lily Kak

Global Development Alliance

Primary Roles: Laerdal: Provide resuscitation devices

and support evaluation AAP: Provide curriculum and build skills

of health providers NICHD: Evaluate Save the Children: Provide technical

leadership USAID, MCHIP, HCI, HealthTech,

CORE : Provide technical leadership and implement at scale

Launched in June 2010; Introduced in over 25 countries to date with 16 receiving USAID support

Adapted from Lily Kak

GDA Achievements to Date -- 1

Conducted HBB training at various levels: ---Global ---Regional (Africa and LAC) ---Country level Translation of HBB materials into French

and Spanish Mobilized funds from other private partners

such as Millennium Cities Initiative, Johnson & Johnson and General Electric

15

GDA Achievements to Date -- 2

Mobilized resources for conducting HBB performance and impact evaluations in selected countries: Malawi, Ethiopia, Bangladesh, Kenya and India

Purchase of HBB training materials at cost

Free license to translate/print HBB materials at country level

Establishment of community of practice Developed HBB implementation guide16

Potential role for PVOs/NGOs

Advocacy for adaptation of the HBB initiative in countries where they work

Facilitate national level planning and coordination

Support adaptation of HBB materials and associated job aids including supervisory, monitoring and evaluation tools Support national/district implementation

Track and report on HBB-related activities

17

HBB Implementing Countries

HELPING BABIES BREATHE CONTACT INFORMATION

Community of practice contact list:Monika Gutestam, Save the Children (mgutestam@savechildren.org)Betsy Hendrickson, USAID (ehendrickson@usaid.gov)Bonnie Koenig, American Academy of Pediatrics (bkoenig@goinginternational.com)Lani Marquez, USAID Health Care Improvement Project/URC (lmarquez@urc-chs.com)Charlene Reynolds, MCHIP (creynolds@mchip.net)

19

HBB link: http://www.helpingbabiesbreathe.org/

www.mchip.net

Follow us on:

THANK YOU!