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Reducing perinatal ...
Reducing perinatal mortality in Nepal using Helping Babies Breathe
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- KC, Ashish, 1982- (author)
- Uppsala universitet,Internationell mödra- och barnhälsovård (IMCH),UNICEF, Health Section, Nepal
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- Wrammert, Johan (author)
- Uppsala universitet,Pediatrik
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- Clark, Robert (author)
- Latter-day Saint Charities, Salt Lake City, Utah, USA
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- Ewald, Uwe (author)
- Uppsala universitet,Internationell mödra- och barnhälsovård (IMCH)
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- Vitrakoti, Ravi (author)
- Paropakar Maternity and Women's Hospital, Kathmandu, Nepal
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- Chaudhary, Pushpa (author)
- Paropakar Maternity and Women's Hospital, Kathmandu, Nepal
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- Pun, Asha (author)
- UNICEF, Health Section, Nepal
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- Raaijmakers, Hendrikus (author)
- UNICEF, Health Section, Nepal
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- Målqvist, Mats (author)
- Uppsala universitet,Internationell mödra- och barnhälsovård (IMCH)
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(creator_code:org_t)
- 2016-06-01
- 2016
- English.
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In: Pediatrics. - : American Academy of Pediatrics (AAP). - 0031-4005 .- 1098-4275. ; 137:6
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Objective: Newborns are at the highest risk of dying around the time of birth, due to intrapartum-related complications. Our study’s objective was to improve adherence to the Helping Babies Breathe (HBB) neonatal resuscitation protocol and reduce perinatal mortality using a quality improvement cycle (QIC) in a tertiary hospital in Nepal. Methods: The HBB QIC was implemented through a multi-faceted approach, including: the formation of quality improvement teams; development of quality improvement goals, objectives and standards; HBB protocol training; weekly review meetings; daily skill checks; use of self-evaluation checklists; and refresher trainings. A cohort design including a nested case-control study was used to measure changes in clinical outcomes and adherence to the resuscitation protocol through video recording, before and after implementation of the QIC. Results: The intrapartum stillbirth rate decreased from 9 to 3.2 per thousand deliveries, and first-day mortality from 5.2 to 1.9 per thousand live births after intervention, demonstrating a reduction of about half in the odds of intrapartum stillbirth (aOR=0.46, 95% CI 0.32-0.66) and first-day mortality (aOR=0.51, 95% CI 0.31-0.83). After intervention, the odds of inappropriate use of suction and stimulation decreased by 87% (OR=0.13, 95% CI 0.09-0.17) and 62% (OR=0.38, 95% CI 0.29-0.49), respectively. Prior to intervention, none of the babies received bag-and-mask ventilation within 1 minute of birth, compared to 83.9% of babies after. Conclusion: The HBB QIC reduced intrapartum stillbirth and first-day neonatal mortality and led to use of suctioning and stimulation more frequently. The HBB QIC requires further testing in primary settings across Nepal.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
Keyword
- intrapartum stillbirth
- intrapartum-related neonatal death
- Helping Babies Breathe
- quality improvement cycle
- Nepal
- International Health
- Internationell hälsa
- Pediatrics
- Pediatrik
Publication and Content Type
- ref (subject category)
- art (subject category)
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Pediatrics
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KC, Ashish, 1982 ...
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Wrammert, Johan
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Clark, Robert
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Ewald, Uwe
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Vitrakoti, Ravi
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Chaudhary, Pushp ...
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show more...
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Pun, Asha
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Raaijmakers, Hen ...
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Målqvist, Mats
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Pediatrics
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Uppsala University