Kristian R Olson1, Aya Caldwell2, Melva Sihombing3, A J Guarino4, Brett D Nelson5, Rebecca Petersen4. 1. Center for Global Health, Massachusetts General Hospital, Boston, MA 02114, United States; Department of Medicine, Clinician Educator Unit, Massachusetts General Hospital, Boston, MA 02114, United States; Division of Global Health, Department of Pediatrics, Massachusetts General Hospital, Boston, MA 02114, United States; Harvard Medical School, Boston, MA 02115, United States. Electronic address: krolson@partners.org. 2. Novartis Foundation for Sustainable Development, Basel CH 4002, Switzerland. 3. Bina Permata Medika School of Health Sciences, Tangerang, Banten, Indonesia. 4. MGH Institute of Health Professionals, Charlestown, MA 02129, United States. 5. Division of Global Health, Department of Pediatrics, Massachusetts General Hospital, Boston, MA 02114, United States; Harvard Medical School, Boston, MA 02115, United States.
Abstract
OBJECTIVES: Newborn deaths comprise an alarming proportion of under-five mortality globally. In this retrospective cohort study, we investigated the effectiveness of focused newborn resuscitation training and delivery of a positive-pressure device in a rural midwife population in a low-resource setting. The present research attempts to better understand the extent to which knowledge and self-efficacy contribute to resuscitation attempts by birth attendants in practice. METHODS: A one-year retrospective cohort analysis was undertaken in Aceh, Indonesia of two groups of community-based midwives, one having received formal training and a positive-pressure resuscitative device and the other receiving usual educational resources and management. A path analysis was undertaken to evaluate relative determinants of actual resuscitation attempts. RESULTS: 348 community-based midwives participated in the evaluation and had attended 3116 births during the preceding year. Path analysis indicated that formal training in resuscitation and delivery of a positive-pressure device were significantly related to both increased knowledge (β=0.55, p=0.001) and increased self-efficacy (β=0.52, p=0.001) in performing neonatal resuscitations with a positive-pressure device. However, training impacted actual resuscitation attempts only indirectly through a relationship with self-efficacy and with knowledge. Combined across groups, self-efficacy was significantly associated with positive pressure ventilation attempts (β=0.26, p<0.01) whereas knowledge was not (β=-0.05, p=0.39). CONCLUSION: Although, to date, evaluations of newborn resuscitation programs have primarily focused on training and has reported process indicators, these results indicate that in order to improve intrapartum-related hypoxic events ("birth asphyxia"), increased emphasis should be placed on participant self-efficacy and mastery of newborn resuscitation.
OBJECTIVES: Newborn deaths comprise an alarming proportion of under-five mortality globally. In this retrospective cohort study, we investigated the effectiveness of focused newborn resuscitation training and delivery of a positive-pressure device in a rural midwife population in a low-resource setting. The present research attempts to better understand the extent to which knowledge and self-efficacy contribute to resuscitation attempts by birth attendants in practice. METHODS: A one-year retrospective cohort analysis was undertaken in Aceh, Indonesia of two groups of community-based midwives, one having received formal training and a positive-pressure resuscitative device and the other receiving usual educational resources and management. A path analysis was undertaken to evaluate relative determinants of actual resuscitation attempts. RESULTS: 348 community-based midwives participated in the evaluation and had attended 3116 births during the preceding year. Path analysis indicated that formal training in resuscitation and delivery of a positive-pressure device were significantly related to both increased knowledge (β=0.55, p=0.001) and increased self-efficacy (β=0.52, p=0.001) in performing neonatal resuscitations with a positive-pressure device. However, training impacted actual resuscitation attempts only indirectly through a relationship with self-efficacy and with knowledge. Combined across groups, self-efficacy was significantly associated with positive pressure ventilation attempts (β=0.26, p<0.01) whereas knowledge was not (β=-0.05, p=0.39). CONCLUSION: Although, to date, evaluations of newborn resuscitation programs have primarily focused on training and has reported process indicators, these results indicate that in order to improve intrapartum-related hypoxic events ("birth asphyxia"), increased emphasis should be placed on participant self-efficacy and mastery of newborn resuscitation.
Authors: Mary Drake; Dunstan R Bishanga; Akwila Temu; Mustafa Njozi; Erica Thomas; Victor Mponzi; Lauren Arlington; Georgina Msemo; Mary Azayo; Allan Kairuki; Amunga R Meda; Kahabi G Isangula; Brett D Nelson Journal: BMC Pediatr Date: 2019-02-07 Impact factor: 2.125
Authors: Min Kyung Kim; Catherine Arsenault; Lynn M Atuyambe; Mubiana Macwan'gi; Margaret E Kruk Journal: BMC Health Serv Res Date: 2020-06-15 Impact factor: 2.655