P0261 - Helping Babies Survive: Lessons Learned from Global Facilitators – The First Decade

Background:
Helping Babies Breathe (HBB) was first launched in 2010 as an evidence-based educational package to train healthcare workers in neonatal resuscitation in low- and middle-income countries (LMIC). Two subsequent curricula, Essential Care fore Every Baby (ECEB) and Essential Care for Small Babies (ECSB), were later added to teach immediate newborn care and management of prematurity. Together, these curricula comprise the Helping Babies Survive (HBS) suite of programs. In the decade since, although much has been learned regarding best practices for effective trainings, overcoming challenges to implementation, and sustaining impactful HBS interventions around the world, there has been no purposeful examination of lessons learned from HBS Trainers. The intent of this study is to gather data on lessons learned from the field, to identify the essential elements of successful HBS interventions worldwide.

Methods:
To estimate the total global reach of the HBS program, we obtained equipment distribution data from Laerdal and HBS material download data from the HBS website as of March 2020. To understand the lessons learned from HBS Trainers who have extensive experience conducting courses, we examined comments from Trainers who recorded their trainings on the HBS website. We also examined HBS Stories from the Field, and other first-hand accounts of lessons learned published on the HBS website.

Results:
More than one million pieces of equipment (simulators, flip charts, provider guides and action plans) have been distributed worldwide. HBS materials have been downloaded from the website more than 130,000 times and have now been translated into 28 languages. HBS equipment and training has reached an estimated 850,000 providers in 158 countries. Qualitative analysis revealed three major themes critical to building sustainable HBS programs: support, planning and local context (See Figure 1). Sub-themes emphasized the importance of 1) having local contacts initiated prior to training, 2) communication with local health care systems and in the local language, 3) frequent and sustained hands-on practice during and after the course, 4) demonstrating success to the learners, 5) identifying gaps in knowledge or care within the local health system, 6) having the adequate time and supplies for training, and 7) adapting to changing situations.

Conclusion:
HBS has had incredible reach worldwide since its inception ten years ago. Lessons learned from experienced trainers represent a vital distillation of first-hand experience into widely applicable knowledge to be utilized to reduce potential failures and achieve desired outcomes. Findings from this study offer further guidance on best practices for implementing and sustaining HBS programs and provide insight into challenges and successes experienced by HBS Trainers working in LMIC settings. Disseminating and sharing these lessons learned can lead to improvements in newborn outcomes throughout the world.