Weill Cornell Medicine and New York-Presbyterian Komansky Children's Hospital, New York, New York;
Department of Pediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Pediatrics. 2020 Oct;146(Suppl 2):S194-S207. doi: 10.1542/peds.2020-016915K.
Helping Babies Breathe (HBB) was piloted in 2009 as a program targeted to reduce neonatal mortality (NM). The program has morphed into a suite of programs termed Helping Babies Survive that includes Essential Care for Every Baby. Since 2010, the HBB and Helping Babies Survive training programs have been taught to >850 000 providers in 80 countries. Initial HBB training is associated with a significant improvement in knowledge and skills. However, at refresher training, there is a knowledge-skill gap evident, with a falloff in skills. Accumulating evidence supports the role for frequent refresher resuscitation training in facilitating skills retention. Beyond skill acquisition, HBB has been associated with a significant reduction in early NM (<24 hours) and fresh stillbirth rates. To evaluate the large-scale impact of the growth of skilled birth attendants, we analyzed NM rates in sub-Saharan Africa ( = 11) and Nepal (as areas of growing HBB implementation). All have revealed a consistent reduction in NM at 28 days between 2009 and 2018; a mean reduction of 5.34%. The number of skilled birth attendants, an indirect measure of HBB sustained rollout, reveals significant correlation with NM, fresh stillbirth, and perinatal mortality rates, highlighting HBB's success and the need for continued efforts to train frontline providers. A novel live newborn resuscitation trainer as well as a novel app (HBB Prompt) have been developed, increasing knowledge and skills while providing simulation-based repeated practice. Ongoing challenges in sustaining resources (financial and other) for newborn programming emphasize the need for innovative implementation strategies and training tools.
《帮助婴儿呼吸》（HBB）于 2009 年作为一个旨在降低新生儿死亡率（NM）的项目试点。该项目已演变为一系列项目，称为《帮助婴儿存活》，其中包括每个婴儿的基本护理。自 2010 年以来，HBB 和《帮助婴儿存活》培训计划已在 80 个国家教授给超过 85 万名提供者。最初的 HBB 培训与知识和技能的显著提高有关。然而，在复习培训中，明显存在知识-技能差距，技能下降。越来越多的证据支持频繁进行复苏培训来促进技能的保持。除了技能的获得，HBB 还与早期 NM（<24 小时）和新鲜死产率的显著降低有关。为了评估熟练接生员人数增长的大规模影响，我们分析了撒哈拉以南非洲（=11）和尼泊尔（作为 HBB 实施增长的地区）的 NM 率。所有这些都显示出 2009 年至 2018 年期间 28 天内 NM 持续下降；平均降幅为 5.34%。熟练接生员人数是 HBB 持续推广的间接指标，与 NM、新鲜死产和围产儿死亡率呈显著相关性，突出了 HBB 的成功以及继续努力培训一线提供者的必要性。还开发了一种新型的新生儿复苏训练器和一种新的应用程序（HBB Prompt），增加了知识和技能，同时提供基于模拟的重复实践。持续存在的维持新生儿编程资源（财务和其他）的挑战强调了需要创新的实施策略和培训工具。
