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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
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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
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HBB Implementing Countries
HELPING BABIES BREATHE CONTACT INFORMATION
Community of practice contact list:Monika Gutestam, Save the Children ([email protected])Betsy Hendrickson, USAID ([email protected])Bonnie Koenig, American Academy of Pediatrics ([email protected])Lani Marquez, USAID Health Care Improvement Project/URC ([email protected])Charlene Reynolds, MCHIP ([email protected])
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HBB link: http://www.helpingbabiesbreathe.org/
www.mchip.net
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THANK YOU!
