Abstract
IntroductionThis study aimed to evaluate the long-term retention of knowledge, skills, and competency of health workers who completed a Helping Babies Breathe (HBB) training program and its effect on newborn mortality.MethodsA quasi-experimental pre- and post-intervention study was conducted. Participants were health workers selected based on their previous training on HBB protocols. Participants were assessed for knowledge, skills, and competency in March 2017 (immediately before and after training), June 2017 (three months after training), and September 2018 (one year after training). Assessments were conducted using HBB questionnaires, checklists and practical skill drills. Mean scores were obtained and ANOVA, chi-squared test, and Pearson's test were used for pre intervention, post intervention, and one-year-after comparisons. The effect of training on the management of newborn asphyxia was assessed based on a review of the delivery registry at a maternity and children's ward. The scores were group into percentages and averages means and were computed using chi-squared tests.ResultsDespite improvements in knowledge, skills, and competency three months after training, participants showed a marked decline one year after training. Knowledge increased from 42.5% pretest to 97% posttest but decreased to 84.5% three months' post training and further decreased to 69.4% one year post training. Skills increased from 26.1% pretest to 94.4% posttest, remained at 94.4% at three months, and decreased to 77.0% at one year. Simple resuscitation scores increased from 26.9% to 88.8% pre- and posttest, remained roughly at three months and decreased to 76.4% at one year. For complex resuscitation, scores decreased from 90.9% posttest to 76.9% at one year. The assessments at one year indicated a need for support and practice, especially with bag-mask ventilation.ConclusionThe immediate evaluation of health workers after HBB training showed significant increases in knowledge, skills and competency in neonatal resuscitation. However, this declined after one year. The training also resulted in decreased neonatal mortality.
Highlights
Of the 200,000 children born annually in South Sudan, an estimated 40% die in the first month of life [1]
The present study aimed to evaluate the retention of knowledge, skills, and competency among health workers and the effects on newborn mortality one year after implementation
The results showed that helping babies is an effective way to address a lack of knowledge among the health workers who are often the first to act in resuscitating newborns with asphyxia
Summary
Of the 200,000 children born annually in South Sudan, an estimated 40% die in the first month of life [1]. The HBB curriculum is designed to train birth attendants in lowresource countries in neonatal resuscitation It is evidence based and geared toward reducing global neonatal mortality. Further studies of HBB curriculum assessment in Africa and Asia using pre- and posttest scores showed significant gains in resuscitation knowledge and skills immediately after training [11, 12]. The evaluation of newborn resuscitation training has shown immediate increases in knowledge, practical skills, and competency, with improved newborn outcomes [13]. There has been limited rigorous evaluation of the retention of knowledge, skills, and competency, and of subsequent newborn outcomes, in low-resource and post conflict settings, such as South Sudan. The present study aimed to evaluate the retention of knowledge, skills, and competency among health workers and the effects on newborn mortality one year after implementation
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