Aims In Ethiopia the neonatal mortality rate is 37/1000 live births and perinatal asphyxia is an important contributor. Like many African countries Ethiopia has made significant progress towards millennium development goal 4 but on present trends is still likely to fall short. Neonatal deaths account for 32% of the under 5 mortality, improving neonatal resuscitation and newborn care is thus key to achieving this goa;. Newborn resuscitation is often not a priority in Ethiopia, even in hospitals there is often no provision for skilled resuscitators to attend high risk deliveries. Various programmes have been developed to address this shortfall but in the authors’ experience they often emphasise theoretical training and fail to reach front line staff.

Methods A ‘Train the Trainers’ model was used to train motivated local staff in methods of teaching, facilitation, practical demonstration and simulation based training, using manikins and real life scenarios. These local trainers were then used to facilitate subsequent training courses with a view to making the project sustainable. All courses were multidisciplinary and emphasised team working and practical skills. Small grant funding from VSO Ethiopia was used to fund the project. In Bahar Dar NLS training was integrated with practical training in managing obstetric emergencies.

Materials ‘Neonatalies’ (Baby manikins) were kindly donated by UNICEF. Teaching materials were adapted from Ethiopian WHO guidelines, NLS guidelines from ALSG and Helping Babies Breathe from the USA.

Results Across two large towns in Ethiopia a total of 124 staff were trained in Newborn Resuscitation, 33 staff were trained as instructors. Instructors included obstetric doctors, paediatric doctors, nurse anaesthetists, midwives and nurses. Success was measured by pre and post course tests and feedback forms.

Conclusions Our experience shows that it is possible to roll out practical neonatal resuscitation with minimal equipment and funding. In order to change attitudes to neonatal resuscitation and care it is vital to empower local staff and trainers rather than rely on a top down approach.