Sharif College of Nursing Lahore, Pakistan.
Aga Khan University, School of Nursing and Midwifery, Karachi, Pakistan.
Midwifery. 2022 Feb;105:103241. doi: 10.1016/j.midw.2021.103241. Epub 2021 Dec 26.
Pakistan's neonatal mortality rate has the highest proportion in the South Asian region and it is higher in the rural areas as compared to the urban areas. Poor resuscitation techniques and lack of basic newborn resuscitation skills in birth attendants are contributing factors towards neonatal deaths. Based on the significant outcomes of the Helping Baby Breath (HBB) training, similar training was implemented for Community Midwives (CMWs) in a low-resource setting in Gujrat, Pakistan, to improve their knowledge and skills. The training evaluation was conducted and participant feedback was obtained through both qualitative and quantitative methods. The findings of the quantitative assessment of the training evaluation will be published elsewhere. This paper presents the qualitative evaluation of the training.
The objective of the study was, to determine the perceptions of HBB trained CMWs about the effectiveness of the HBB training, and the challenges faced in the implementation of HBB skills for newborn resuscitation, at their work settings.
The qualitative descriptive design was used in this study. The purposive sampling technique was chosen to recruit midwives and key informants as participants of the training. Interviews were conducted by using a semi-structured interview guide. The study included a total of five interviews: two focus group interviews for CMWs (10 in each group), and three individual interviews of key informants.
The content analysis of the qualitative data yielded three themes: the effectiveness of training, challenges, and suggestions. The findings revealed that the HBB training was effective for the CMWs in terms of its usability, regarding improvement in newborn resuscitation knowledge and skills. Moreover, it enhanced confidence and satisfaction in CMWs. However, less volume of patients was a challenge for a few CMWs with regard to practicing their skills.
Due to the inadequate number of patients and fewer opportunities of practice for several CMWs, they required such training frequently, in order to maintain their competency. The CMWs also recommended that HBB training should be part of the Midwifery program curriculum. Moreover, similar training was also recommended for other healthcare providers working in low-resource settings, including doctors and nurses.
巴基斯坦的新生儿死亡率在南亚地区占比最高，且农村地区的这一比例高于城市地区。复苏技术不佳以及接生员缺乏基本的新生儿复苏技能是导致新生儿死亡的因素之一。基于 Helping Baby Breath（HBB）培训的显著成果，在巴基斯坦古吉拉特邦的资源匮乏环境中，为社区助产士实施了类似的培训，以提高他们的知识和技能。培训评估是通过定性和定量方法进行的，并获得了参与者的反馈。培训评估的定量评估结果将在其他地方发表。本文介绍了培训的定性评估。
本研究的目的是确定接受过 HBB 培训的社区助产士对 HBB 培训效果的看法，以及他们在工作场所实施新生儿复苏 HBB 技能时面临的挑战。
本研究采用定性描述性设计。选择目的抽样技术招募助产士和关键信息提供者作为培训参与者。使用半结构化访谈指南进行访谈。该研究共包括五次访谈：两组社区助产士（每组 10 人）进行两次焦点小组访谈，以及三位关键信息提供者进行三次个人访谈。
对定性数据的内容分析产生了三个主题：培训的有效性、挑战和建议。研究结果表明，HBB 培训在提高社区助产士新生儿复苏知识和技能方面非常有效，而且提高了他们的信心和满意度。然而，对于少数社区助产士来说，患者数量较少是实践技能的一个挑战。
由于少数社区助产士的患者数量不足，实践机会较少，他们需要经常接受此类培训，以保持他们的能力。社区助产士还建议 HBB 培训应成为助产士课程的一部分。此外，还建议在资源匮乏环境中工作的其他医护人员，包括医生和护士，接受类似的培训。
