Does the Helping Babies Breathe Programme impact on neonatal resuscitation care practices? Results from systematic review and meta‐analysis

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Aim

This paper examines the change in neonatal resuscitation practices after the implementation of the Helping Babies Breathe (HBB) programme.

Methods

A systematic review was carried out on studies reporting the impact of HBB programmes among the literature found in Medline, POPLINE, LILACS, African Index Medicus, Cochrane, Web of Science and Index Medicus for the Eastern Mediterranean Region database. We selected clinical trials with randomised control, quasi‐experimental and cross‐sectional designs. We used a data extraction tool to extract information on intervention and outcome reporting. We carried out a meta‐analysis of the extracted data on the neonatal resuscitation practices following HBB programme using Review Manager.

Results

Four studies that reported on neonatal resuscitation practices before and after the implementation of the HBB programme were identified. The pooled results showed no changes in the use of stimulation (RR‐0.54; 95% CI, 0.21–1.42), suctioning (RR‐0.48; 95% CI, 0.18–1.27) and bag‐and‐mask ventilation (RR‐0.93; 95% CI, 0.47–1.83) after HBB training. The proportion of babies receiving bag‐and‐mask ventilation within the Golden Minute of birth increased by more than 2.5 times (RR‐2.67; 95% CI, 2.17–3.28).

Conclusion

The bag‐and‐mask ventilation within Golden minute has improved following the HBB programme. Implementation of HBB training improves timely initiation of bag‐and‐mask ventilation within one minute of birth.

Related collections

Most cited references 16

Record: found
Abstract: found
Article: not found

Testing a tool for assessing the risk of bias for nonrandomized studies showed moderate reliability and promising validity.

Soo Young Kim, Ji Eun Park, Yoon Lee … (2013)

To develop and validate a new risk-of-bias tool for nonrandomized studies (NRSs). We developed the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS). A validation process with 39 NRSs examined the reliability (interrater agreement), validity (the degree of correlation between the overall assessments of RoBANS and Methodological Index for Nonrandomized Studies [MINORS], obtained by plotting the overall risk of bias relative to effect size and funding source), face validity with eight experts, and completion time for the RoBANS approach. RoBANS contains six domains: the selection of participants, confounding variables, the measurement of exposure, the blinding of the outcome assessments, incomplete outcome data, and selective outcome reporting. The interrater agreement of the RoBANS tool except the measurement of exposure and selective outcome reporting domains ranged from fair to substantial. There was a moderate correlation between the overall risks of bias determined using RoBANS and MINORS. The observed differences in effect sizes and funding sources among the assessed studies were not correlated with the overall risk of bias in these studies. The mean time required to complete RoBANS was approximately 10 min. The external experts who were interviewed evaluated RoBANS as a "fair" assessment tool. RoBANS shows moderate reliability, promising feasibility, and validity. The further refinement of this tool and larger validation studies are required. Copyright © 2013 Elsevier Inc. All rights reserved.

0 comments Cited 413 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Neonatal resuscitation and immediate newborn assessment and stimulation for the prevention of neonatal deaths: a systematic review, meta-analysis and Delphi estimation of mortality effect

Anne Lee, Simon Cousens, Stephen Wall … (2011)

Background Of 136 million babies born annually, around 10 million require assistance to breathe. Each year 814,000 neonatal deaths result from intrapartum-related events in term babies (previously “birth asphyxia”) and 1.03 million from complications of prematurity. No systematic assessment of mortality reduction from tactile stimulation or resuscitation has been published. Objective To estimate the mortality effect of immediate newborn assessment and stimulation, and basic resuscitation on neonatal deaths due to term intrapartum-related events or preterm birth, for facility and home births. Methods We conducted systematic reviews for studies reporting relevant mortality or morbidity outcomes. Evidence was assessed using GRADE criteria adapted to provide a systematic approach to mortality effect estimates for the Lives Saved Tool (LiST). Meta-analysis was performed if appropriate. For interventions with low quality evidence but strong recommendation for implementation, a Delphi panel was convened to estimate effect size. Results We identified 24 studies of neonatal resuscitation reporting mortality outcomes (20 observational, 2 quasi-experimental, 2 cluster randomized controlled trials), but none of immediate newborn assessment and stimulation alone. A meta-analysis of three facility-based studies examined the effect of resuscitation training on intrapartum-related neonatal deaths (RR= 0.70, 95%CI 0.59-0.84); this estimate was used for the effect of facility-based basic neonatal resuscitation (additional to stimulation). The evidence for preterm mortality effect was low quality and thus expert opinion was sought. In community-based studies, resuscitation training was part of packages with multiple concurrent interventions, and/or studies did not distinguish term intrapartum-related from preterm deaths, hence no meta-analysis was conducted. Our Delphi panel of 18 experts estimated that immediate newborn assessment and stimulation would reduce both intrapartum-related and preterm deaths by 10%, facility-based resuscitation would prevent a further 10% of preterm deaths, and community-based resuscitation would prevent further 20% of intrapartum-related and 5% of preterm deaths. Conclusion Neonatal resuscitation training in facilities reduces term intrapartum-related deaths by 30%. Yet, coverage of this intervention remains low in countries where most neonatal deaths occur and is a missed opportunity to save lives. Expert opinion supports smaller effects of neonatal resuscitation on preterm mortality in facilities and of basic resuscitation and newborn assessment and stimulation at community level. Further evaluation is required for impact, cost and implementation strategies in various contexts. Funding This work was supported by the Bill & Melinda Gates Foundation through a grant to the US Fund for UNICEF, and to the Saving Newborn Lives program of Save the Children, through Save the Children US.

0 comments Cited 141 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Standards for CHERG reviews of intervention effects on child survival

Neff Walker, Christa Fischer-Walker, Jennifer Bryce … (2010)

Background The Lives Saved Tool (LiST) uses estimates of the effects of interventions on cause-specific child mortality as a basis for generating projections of child lives that could be saved by increasing coverage of effective interventions. Estimates of intervention effects are an essential element of LiST, and need to reflect the best available scientific evidence. This article describes the guidelines developed by the Child Health Epidemiology Reference Group (CHERG) that are applied by scientists conducting reviews of intervention effects for use in LiST. Methods The guidelines build on and extend those developed by the Cochrane Collaboration and the Working Group for Grading of Recommendations Assessment, Development and Evaluation (GRADE). They reflect the experience gained by the CHERG intervention review groups in conducting the reviews published in this volume, and will continue to be refined through future reviews. Presentation of the guidelines Expected products and guidelines are described for six steps in the CHERG intervention review process: (i) defining the scope of the review; (ii) conducting the literature search; (iii) extracting information from individual studies; (iv) assessing and summarizing the evidence; (v) translating the evidence into estimates of intervention effects and (vi) presenting the results. Conclusions The CHERG intervention reviews represent an ambitious effort to summarize existing evidence and use it as the basis for supporting sound public health decision making through LiST. These efforts will continue, and a similar process is now under way to assess intervention effects for reducing maternal mortality.

0 comments Cited 110 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Ashish KC:

ORCID: https://orcid.org/0000-0002-0541-4486

aaashis7@yahoo.com

Journal

Journal ID (nlm-ta): Acta Paediatr

Journal ID (iso-abbrev): Acta Paediatr

Journal ID (doi): 10.1111/(ISSN)1651-2227

Journal ID (publisher-id): APA

Title: Acta Paediatrica (Oslo, Norway : 1992)

Publisher: John Wiley and Sons Inc. (Hoboken )

ISSN (Print): 0803-5253

ISSN (Electronic): 1651-2227

Publication date (Electronic): 24 January 2019

Publication date (Print): May 2019

Volume: 108

Issue: 5 ( doiID: 10.1111/apa.2019.108.issue-5 )

Pages: 806-813

Affiliations

[ ¹ ] School of Public Health and Community Medicine B.P Koirala Institute of Health Sciences Dharan Nepal

[ ² ] Golden Community Jawagal Nepal

[ ³ ] International Maternal and Child Health Department of Women's and Children's Health Uppsala University Uppsala Sweden

Author notes

[*] [* ] Correspondence

Ashish KC, International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Tel: +9779841453806 |

Fax: +97715114171 |

Email: aaashis7@ 123456yahoo.com

Author information

Ashish KC https://orcid.org/0000-0002-0541-4486

Article

Publisher ID: APA14706

DOI: 10.1111/apa.14706

PMC ID: 6590361

PubMed ID: 30582888

SO-VID: e83c9d3b-44ee-465b-9ffa-9d876360a4f3

License:

This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

History

Date received : 09 October 2018

Date revision received : 25 November 2018

Date accepted : 19 December 2018

Page count

Figures: 5, Tables: 4, Pages: 8, Words: 5478

Custom metadata

source-schema-version-number 2.0

component-id apa14706

cover-date May 2019

details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.4 mode:remove_FC converted:24.06.2019

ScienceOpen disciplines: Pediatrics

Keywords: helping babies breathe,low‐and middle‐income countries,neonatal resuscitation,ventilation within one minute of birth

Data availability:

ScienceOpen disciplines: Pediatrics

Keywords: helping babies breathe, low‐and middle‐income countries, neonatal resuscitation, ventilation within one minute of birth

Does the Helping Babies Breathe Programme impact on neonatal resuscitation care practices? Results from systematic review and meta‐analysis

Read this article at

Abstract

Aim

Methods

Results

Conclusion

Related collections

Pediatric Pulse: Advancing Neonatal and Child Health

Most cited references 16

Testing a tool for assessing the risk of bias for nonrandomized studies showed moderate reliability and promising validity.

Neonatal resuscitation and immediate newborn assessment and stimulation for the prevention of neonatal deaths: a systematic review, meta-analysis and Delphi estimation of mortality effect

Standards for CHERG reviews of intervention effects on child survival

Author and article information

Contributors

Journal

Affiliations

Author notes

Author information

Article

History

Page count

Categories

Custom metadata

Comments

Comment on this article

Similar content 113

Cited by 12

Most referenced authors 1,110