Sendo Endalew Gemechu, Aga Fekadu, Gebrewold Lemi Abebe
Department of Midwifery, College of Health Sciences, Addis Ababa University, >Addis Ababa, Ethiopia.
Department of Nursing, School of Nursing and Midwifery, College of Health Sciences, AAU, >Addis Ababa, Ethiopia.
Matern Health Neonatol Perinatol. 2025 Jun 2;11(1):15. doi: 10.1186/s40748-025-00201-2.
Neonatal mortality remains a significant public health challenge in Ethiopia, often attributed to asphyxia at birth. Helping Babies Breathe (HBB), an evidence-based neonatal resuscitation program aims to address this issue. However, the sustainability of knowledge and skills acquired during pre-service training is less understood.
This study assessed the retention of knowledge and skills among midwives one year after completing the HBB pre-service training in Ethiopia.
A non-randomized quasi-experimental study was conducted involving a cohort of midwifery graduates who completed HBB training during their final year. Knowledge was assessed using a multiple-choice questionnaire, while skills were evaluated using Objective Structured Clinical Examinations (OSCEs). Data were collected immediately post-training, six months later, and one year later. Paired t-tests and Wilcoxon signed-rank tests were used to analyze changes over time.
Of the 60 midwives initially trained, 50 (83.3%) participated in the follow-up assessment. The median knowledge score decreased significantly from 98% immediately post-training to 74% one year later (p < 0.01). Similarly, OSCE performance declined, with 36% of participants demonstrating proficiency compared to 62% at baseline (p < 0.05). A paired t-test was performed to evaluate whether students' psychomotor skills significantly declined 12 months after initial training. The results of the analysis showed a highly significant decline in psychomotor skills during this time, with a mean difference of -2.29 (SE = 0.29; p < 0.001). This negative mean difference, with pre-test scores averaging 27.59 (SD = 2.78) and post-test scores after 12 months averaging 25.31 (SD = 2.11), indicates a noticeable drop in skill levels following training.
While midwives retained moderate knowledge and skills one year after completing HBB training, significant attrition highlights the need for periodic refresher training and improved access to resuscitation tools. Strengthening these aspects may enhance the long-term impact of HBB in reducing neonatal mortality.
在埃塞俄比亚，新生儿死亡率仍然是一项重大的公共卫生挑战，通常归因于出生时的窒息。“帮助宝宝呼吸”（HBB）是一项基于证据的新生儿复苏计划，旨在解决这一问题。然而，对于职前培训期间所获得知识和技能的可持续性，人们了解较少。
本研究评估了埃塞俄比亚助产士在完成HBB职前培训一年后知识和技能的保持情况。
进行了一项非随机准实验研究，涉及一组在最后一年完成HBB培训的助产专业毕业生。知识通过多项选择题问卷进行评估，技能则使用客观结构化临床考试（OSCE）进行评估。在培训结束后立即、六个月后和一年后收集数据。采用配对t检验和Wilcoxon符号秩检验分析随时间的变化。
最初接受培训的60名助产士中，50名（83.3%）参与了随访评估。知识得分中位数从培训后立即的98%显著下降到一年后的74%（p < 0.01）。同样，OSCE表现也有所下降，36%的参与者表现熟练，而基线时为62%（p < 0.05）。进行配对t检验以评估学生的操作技能在初始培训12个月后是否显著下降。分析结果显示，在此期间操作技能有极显著下降，平均差异为-2.29（标准误 = 0.29；p < 0.001）。这个负的平均差异，前测分数平均为27.59（标准差 = 2.78），12个月后的后测分数平均为25.31（标准差 = 2.11），表明培训后技能水平有明显下降。
虽然助产士在完成HBB培训一年后保留了一定的知识和技能，但显著的损耗凸显了定期进修培训以及改善复苏工具获取途径的必要性。加强这些方面可能会增强HBB在降低新生儿死亡率方面的长期影响。
