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Perinatal outcomes following Helping Babies Breathe training and regular peer–peer skills practice among village midwives in Sudan
  1. AME Arabi1,
  2. SA Ibrahim1,
  3. M Abdel-Rahman2,3,
  4. MS Abdalla1,
  5. SE Ahmed4,
  6. EP Dempsey4,
  7. CA Ryan4
  1. 1Department of Paediatrics and Child Health, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
  2. 2Department of Statistics, Faculty of Mathematical Sciences, University of Khartoum, Khartoum, Sudan
  3. 3Department of Public Health, College of Health Sciences, Qatar University, Doha, Qatar
  4. 4Department of Paediatrics and Child Health, Cork University Maternity Hospital, Cork, Ireland
  1. Correspondence to Dr AME Arabi, Department of Paediatrics and Child Health, Faculty of Medicine, University of Khartoum, PO Box 102, Khartoum, Sudan; draliarabi99{at}gmail.com

Abstract

Background Over 80% of deliveries in Sudan occur in rural areas, attended by village midwives (VMWs).

Objective To determine the impact of Helping Babies Breathe training and regular peer–peer skills practice (HBBT+RPPSP) on VMW resuscitation practices and outcomes.

Methods In a prospective community-based intervention study, 71/82 VMWs, reporting to six East Nile rural medical centres, with previous experience in community health research, consented to HBBT+RPPSP. Outcomes included changes in the resuscitation practices, fresh stillbirths (FSB) and early neonatal deaths <1 week (ENND).

Results There were 1350 and 3040 deliveries before and after HBBT+RPPSP, respectively, with no significant differences between the two cohorts regarding maternal age, education or area of birth. Drying of the newborn increased almost tenfold (8.4%, n=113 to 74.9%, n=1011) while suctioning of the mouth/nose decreased fivefold (80.3%, n=2442 to 14.4%, n=437) following HBBT+RPPSP. Pre-HBBT+RPPSP9/18 (50%) newborns who had mouth-to-mouth ventilation died, compared with 13/119 (11%) who received bag-mask ventilation post-HBBT+RPPSP. Excluding 11 macerated fetuses, there were 55 perinatal deaths: 14 FSB/18 ENND (6 months pre-HBBT+RPPSP) and 10 FSB/13 ENND (18 months post-HBBT+RPPSP). FSB rates decreased from 10.5 to 3.3 per 1000 births ((χ2)=8.6209, p=0.003), while ENND rates decreased from 13.5 to 4.3 per 1000 live births ((χ2)=10.9369, p=0.001) pre-HBBT+RPPSP and post-HBBT+RPPSP, respectively.

Conclusion In a selected group of VMWs, HBBT+RPPSP was associated with improvements in newborn resuscitation and perinatal outcomes. HBBT+RPPSP could have immense benefits if propagated nationally to all 17 000 VMWs in Sudan.

  • helping babies breathe
  • village midwife
  • newborn resuscitation
  • resuscitation skills
  • sudan

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Footnotes

  • Funding This study was funded by the Irish Aid Civil Society Grant scheme.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All available data can be obtained by contacting the corresponding author.

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