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Helping Babies Breathe AmandaHigginson,MD
November9,2016
Outline
• Theproblem• Asolu>on• Theevidence• Hands-on
*ThemajorityoftheseslidesarefromDr.CarlBose’spresenta>onatthe2015AAPNCE*
GlobalNeonatalHealth
Mostofthesedeathsarepreventable!
• 3.8neonataldeaths(3.2millions>llbirths)
• ~3xdeathsduetoHIV/AIDsandmalariacombined
• >400neonataldeathseachhour
Wheredomostneonataldeathsoccur?
Oestergaardetal.PLoSMed2011
WhatCausesNeonatalDeath?
WhatCausesNeonatalDeath?
Whatcanbedone?
Improvedresuscita?on
• Pretermlabormanagement• KMC• Alternatefeedingtechniques
• Cordcare• Improvedhygiene• ExclusivebreasHeeding
DHS 2006-2008. Service Provision Assessment: 2002-2010. MACRO International Inc
Access to newborn resuscitation is severely limited
The challenge
71
57
43
81
69
50
42
9 14 14
23
5 6 8
24 22
31
50
25
8
15
0
10
20
30
40
50
60
70
80
90
Egypt Ghana Kenya Namibia Rwanda Tanzania Uganda
Perc
enta
ge
% of all babies born in facilities
% of all babies born by staff trained in neonatal resuscitation
% of all babies born in facilities with newborn respiratory equipment
Asphyxia: Major cause of newborn death
Liu et al. Lancet , May 11, 2012
Preterm 35 %
Asphyxia 23 %
Congenital 9 %
Infections 27 %
Other 6 %
The challenge
TheHelpingBabiesSurvivePrograms:Educa?onalProgramstoImproveNeonatalOutcomes
2015 NRP® Current Issues Seminar
EDUCATIONALDESIGN
SIMPLE HANDSON CO-OPERATIVELEARNING
EDUCATIONALDESIGNPURPOSEFULDEVELOPMENTOFEDUCATIONALMODELS
BagandMaskVen>la>on Expressionbreastmilk Nasogastrictubefeeding
Spurs new medical device innovations
¾ Openable for cleaning ¾ Boilable for disinfection ¾ Reusable 100s of times ¾ Highly affordable ($ 3)
Reusable newborn suction device
¾ Better mask seal ¾ Fewer parts ¾ Easier to clean ¾ Lower cost
«Upright» resuscitator
HelpingBabiesBreathe(HBB)
Ac#onPlan
• Ac>onPlan• FacilitatorFlipChart• LearnerWorkbook
• NeonatalSimulator• BagandMask• Suc>onDevice
HelpingBabiesBreatheMaterials
ResultsfromtheField:Tanzania
ResultsfromtheField:Nepal
Pediatrics.2016;137(6):e20150117
Lotsofongoingresearch
Essen?alCareforEveryBaby(ECEB)
Ac#onPlan
• Ac>onPlan• FacilitatorFlipchart• ProviderGuide• ParentGuide
Essen?alCareforEveryBaby
Materials
Essen?alCarefor
EveryBaby
ParentGuide
Essen?alCareforSmallBabies(ECSB)
Ac#onPlan
• Ac>onPlan• FacilitatorFlipchart• ProviderGuide• ParentGuide
Essen?alCareforSmallBabies
Materials
ExpressionofBreastMilk
NasogastricTubeFeeding
Improvedresuscita?on
• Cordcare• Improvedhygiene• ExclusivebreasHeeding
TheHelpingBabiesSurvivePrograms • Pretermlabormanagement
• KMC• Alternatefeedingtechniques
MeetNeoNatalie
HelpingBabiesBreathe,ROC
THANKYOU!
Helpbabiesbreathiftheydonotcryatbirth.Provideessen#al
caretoallbabies.
Keepsmallbabieswellandhelpthemgrow.