P0250 - Building Local Capacity with Helping Babies Survive

Background: Health care workforce training is essential in low- and middle-income countries (LMIC). Professional organizations, government agencies, and non-governmental organizations (NGOs) all assist with training, but often lack the capacity to fully disseminate basic skills and knowledge. Collaboration between Latter-day Saint Charities (LDSC) and LMIC in-country partners has increased training, improved outcomes, and built capacity in the partners.

Since the launch of Helping Babies Breathe (HBB) LDSC has sponsored HBB training courses in 68 countries. LDSC has also sponsored training in all modules of Helping Babies Survive (HBS) and in Helping Mothers Survive (HMS). LDSC’s partnerships in Vietnam, Uzbekistan, Indonesia, and East Africa serve as examples of building capacity while improving outcomes through HBS training.

Methods: In 2010 LDSC began sponsoring HBB courses in LMIC worldwide, HBS and HMS modules were subsequently added. LDSC provided translated HBS instructional materials (35 translations), training mannequins (30,895 NeoNatalies) and delivery room equipment (bags and masks) to facilitate immediate clinical and teaching applications (Table 1).

Results:
Indonesia: LDSC partnered with the Indonesian Society of Perinatology (Perinasia) and the District Health Office to introduce HBB in Bandung District, resulting in a 60% decrease in cases of neonatal asphyxia in that area in one year.

Rwanda, Tanzania, and Ethiopia – 50,000 Happy Birthdays: LDSC partnered with the International Confederation of Midwives (ICM) for master trainer courses followed by technical expertise and funding. In Rwanda, bag/mask ventilation for babies not crying at birth increased by 9.7%, early neonatal deaths decreased by 57% and fresh stillbirths by 14%.

Uzbekistan: LDSC partnered with the Ministry of Health and UNICEF to disseminate HBB and ECEB training, and to provide equipment and protocols for hospitals and pre-service schools throughout the country. The Ministry reported that early neonatal deaths in 2017-2017 due to asphyxia decreased from 13% to 10%, and that late neonatal deaths due to asphyxia decreased from 13.2% to 7.3%.

Vietnam: LDSC partnered with VietHealth and the MOH to include HBB in the national standard of care, initiating a cascade of training beginning with provincial-level hospitals. An innovative two-day Supportive Supervision training program was included to improve teaching and sustainability of new skills.

Discussion: Over the first 10 years of HBB, LDSC has helped partners build the capacity to recruit, maintain, and monitor networks of trainers, and raise their visibility with local and national governments. In several countries national governments have adopted HBS as the national standard of care and/or the preferred pre-service curriculum. In partnership with LDSC, professional organizations, NGOs, and INGOs have extended their reach ‘beyond the grant’ to immediately implement new skills, establish practice systems, and sustain the skills after the training.

Conclusion: LDSC partnerships have expanded HBS training, improved outcomes, and built local organizational capacity.