Nkwen Baptist Hospital, Bamenda, Cameroon.
Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya.
Pan Afr Med J. 2022 Jul 1;42:169. doi: 10.11604/pamj.2022.42.169.32816. eCollection 2022.
neonatal mortality accounts for the most significant proportion of under-five mortality worldwide, as in Cameroon. Birth asphyxia is the leading cause of neonatal deaths in Cameroon. Training of health care workers (HCWs) in newborn resuscitation reduces neonatal morbidity and mortality. In this study, we evaluated the effect of in-hospital training on the competence (knowledge and skills) of HCWs in newborn resuscitation at Mboppi Baptist Hospital, Douala, Cameroon.
this was a quasi-experimental study done in five weeks, in which we compared knowledge and skills before and after training. Assessment of knowledge and skills of HCWs in newborn resuscitation was done before training (simulations) and a week after training using World Health Organization (WHO) adapted Emergency Triage Assessment and Treatment (ETAT+) standard tool. Three key informant interviews (KIIs) and a focused group discussion (FGD) were held to determine barriers to effective newborn resuscitation. Data were analyzed using R software version 3.6.2. McNemar test and Cohen´s Kappa were used to analyze quantitative data, while major themes from KIIs and FGDs were selected for qualitative data.
we enrolled 30 HCWs, each HCW was observed twice, a total of 60 deliveries observed before and 60 after training. Sixteen HCWs (53%) showed adequate knowledge before and after training. Median scores for skills significantly increased by 28% (p<0.00054) for real-life observations and 26% (p=0.0004) for newborn resuscitation scenario simulations. The main barriers to adequate newborn resuscitation were inadequate knowledge, equipment, shortage of trained staff and poor teamwork between midwives and anesthetists.
in-hospital training on newborn resuscitation improved the skills of HCWs but had no significant effect on their knowledge on newborn resuscitation. We would recommend that in-hospital training in newborn resuscitation be done often for HCWs.
新生儿死亡占全球五岁以下儿童死亡的最大比例，喀麦隆也是如此。出生窒息是喀麦隆新生儿死亡的主要原因。对卫生保健工作者（HCWs）进行新生儿复苏培训可降低新生儿发病率和死亡率。在这项研究中，我们评估了在 Mboppi Baptist 医院（喀麦隆杜阿拉）对 HCWs 进行院内新生儿复苏培训对其能力（知识和技能）的影响。
这是一项为期五周的准实验研究，我们比较了培训前后的知识和技能。在培训前（模拟）和培训后一周，使用世界卫生组织（WHO）改编的紧急分类评估和治疗（ETAT+）标准工具评估 HCWs 新生儿复苏的知识和技能。进行了三次关键知情人访谈（KII）和一次焦点小组讨论（FGD），以确定有效新生儿复苏的障碍。使用 R 软件版本 3.6.2 分析数据。McNemar 检验和 Cohen's Kappa 用于分析定量数据，而 KII 和 FGD 的主要主题则用于分析定性数据。
我们招募了 30 名 HCWs，每位 HCW 观察两次，总共观察了 60 次培训前和 60 次培训后的分娩。16 名 HCWs（53%）在培训前后表现出足够的知识。现实生活观察的技能评分中位数显著提高了 28%（p<0.00054），新生儿复苏情景模拟的技能评分中位数提高了 26%（p=0.0004）。适当新生儿复苏的主要障碍是知识不足、设备不足、训练有素的人员短缺以及助产士和麻醉师之间的团队合作不佳。
院内新生儿复苏培训提高了 HCWs 的技能，但对其新生儿复苏知识没有显著影响。我们建议经常为 HCWs 提供院内新生儿复苏培训。
