Mapping Evidence of Neonatal Resuscitation Training on the Practices of Unskilled Birth Attendants in Low-Resource Countries: Protocol for a Scoping Review.

Busisiwe Purity Ncama,Hafaza Amod,Adenike Adebola Olaniyi

doi:10.2196/18935

Abstract

BackgroundCompetence in neonatal resuscitation of the newborn is very critical to ensure the safety and well-being of newborn infants. The acquisition of neonatal resuscitation skills by birth attendants improves self-efficacy, thereby reducing neonatal mortality as a result of asphyxia. Approximately one-quarter of all neonatal deaths globally are caused by birth asphyxia. The need for neonatal resuscitation is most imperative in resource-constrained settings, where access to intrapartum obstetric care is inadequate.ObjectiveThis protocol describes the methodology of a scoping review on evidence of training in neonatal resuscitation and its association with practice in low-resource countries. The aim of the review is to map the available evidence of neonatal resuscitation training on the practices of unskilled birth attendants.MethodsThe scoping review will use the Population, Concept, and Context (PCC) framework proposed by Arksey and O’Malley, refined by Levac et al, and published by Joanna Briggs Institute, while following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. The search strategy was developed with the assistance of the college librarian. A number of databases of peer-reviewed research (PsycINFO and Wiley Online Library [via EBSCOhost], PubMed, MEDLINE with full text, Google Scholar [via ScienceDirect], and CINAHL Plus with full text [via EBSCOhost]) and databases committed to grey literature sources will be searched, and reference extraction will be performed. Two independent reviewers will screen and extract data, and discrepancies will be resolved by a third reviewer. The extracted data will undergo a descriptive analysis of contextual data and a quantitative analysis using appropriate statistical methods.ResultsData relating to neonatal resuscitation training and practices in low-resource settings will be extracted and included for analysis. We expect that the review will be completed 12 months from the publication of this protocol.ConclusionsThis scoping review will focus on the review of evidence and provide an insight into the existing literature to guide further research and identify implementation strategies to improve the practices of unskilled birth attendants through the acquisition of skills and self-efficacy in neonatal resuscitation. The results of this review will be presented at relevant conferences related to newborn and child health and neonatal nursing studies and published in a peer-reviewed journal.International Registered Report Identifier (IRRID)DERR1-10.2196/18935

Highlights

An estimated 10 million babies need help to initiate breathing, all babies require an immediate assessment at birth [1]
Data relating to neonatal resuscitation training and practices in low-resource settings will be extracted and included for analysis
The results of this review will be presented at relevant conferences related to newborn and child health and neonatal nursing studies and published in a peer-reviewed journal

Summary

Introduction

An estimated 10 million babies need help to initiate breathing, all babies require an immediate assessment at birth [1]. 5% to 10% of all babies born in health facilities need some measure of resuscitation, including tactile stimulation, airway clearance, and positioning [2]. According to the report of the World Health Organization (WHO), approximately 3% to 6% of neonates require basic neonatal resuscitation, which consists of simple initial steps as well as assisted ventilation [3]. Neonatal resuscitation refers to a set of interventions performed at the time of birth to support the establishment of breathing and circulation in newborns [4]. Performing basic resuscitation with bag and mask is required for babies who cannot breathe and sufficient to resuscitate neonates with secondary apnea [4]. Advanced resuscitation (performed by skilled birth attendants), which comprises chest compressions, intubation, or medication, is essential for approximately 2% of all nonbreathing babies [5]. The need for neonatal resuscitation is most imperative in resource-constrained settings, where access to intrapartum obstetric care is inadequate

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Discussion

Conclusion