Effect of newborn resuscitation training on health worker practices in Pumwani Hospital, Kenya.

Birth asphyxia kills 0.7 to 1.6 million newborns a year globally with 99% of deaths in developing countries. Effective newborn resuscitation could reduce this burden of disease but the training of health-care providers in low income settings is often outdated. Our aim was to determine if a simple on...

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Main Authors: Newton Opiyo, Fred Were, Fridah Govedi, Greg Fegan, Aggrey Wasunna, Mike English
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2008-02-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC2229665?pdf=render
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author Newton Opiyo
Fred Were
Fridah Govedi
Greg Fegan
Aggrey Wasunna
Mike English
author_facet Newton Opiyo
Fred Were
Fridah Govedi
Greg Fegan
Aggrey Wasunna
Mike English
author_sort Newton Opiyo
collection DOAJ
description Birth asphyxia kills 0.7 to 1.6 million newborns a year globally with 99% of deaths in developing countries. Effective newborn resuscitation could reduce this burden of disease but the training of health-care providers in low income settings is often outdated. Our aim was to determine if a simple one day newborn resuscitation training (NRT) alters health worker resuscitation practices in a public hospital setting in Kenya.We conducted a randomised, controlled trial with health workers receiving early training with NRT (n = 28) or late training (the control group, n = 55). The training was adapted locally from the approach of the UK Resuscitation Council. The primary outcome was the proportion of appropriate initial resuscitation steps with the frequency of inappropriate practices as a secondary outcome. Data were collected on 97 and 115 resuscitation episodes over 7 weeks after early training in the intervention and control groups respectively. Trained providers demonstrated a higher proportion of adequate initial resuscitation steps compared to the control group (trained 66% vs control 27%; risk ratio 2.45, [95% CI 1.75-3.42], p<0.001, adjusted for clustering). In addition, there was a statistically significant reduction in the frequency of inappropriate and potentially harmful practices per resuscitation in the trained group (trained 0.53 vs control 0.92; mean difference 0.40, [95% CI 0.13-0.66], p = 0.004).Implementation of a simple, one day newborn resuscitation training can be followed immediately by significant improvement in health workers' practices. However, evidence of the effects on long term performance or clinical outcomes can only be established by larger cluster randomised trials.Controlled-Trials.com ISRCTN92218092.
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spelling doaj.art-6845b4ee76de4d3a88dbdfc49cc905822022-12-22T00:22:27ZengPublic Library of Science (PLoS)PLoS ONE1932-62032008-02-0132e159910.1371/journal.pone.0001599Effect of newborn resuscitation training on health worker practices in Pumwani Hospital, Kenya.Newton OpiyoFred WereFridah GovediGreg FeganAggrey WasunnaMike EnglishBirth asphyxia kills 0.7 to 1.6 million newborns a year globally with 99% of deaths in developing countries. Effective newborn resuscitation could reduce this burden of disease but the training of health-care providers in low income settings is often outdated. Our aim was to determine if a simple one day newborn resuscitation training (NRT) alters health worker resuscitation practices in a public hospital setting in Kenya.We conducted a randomised, controlled trial with health workers receiving early training with NRT (n = 28) or late training (the control group, n = 55). The training was adapted locally from the approach of the UK Resuscitation Council. The primary outcome was the proportion of appropriate initial resuscitation steps with the frequency of inappropriate practices as a secondary outcome. Data were collected on 97 and 115 resuscitation episodes over 7 weeks after early training in the intervention and control groups respectively. Trained providers demonstrated a higher proportion of adequate initial resuscitation steps compared to the control group (trained 66% vs control 27%; risk ratio 2.45, [95% CI 1.75-3.42], p<0.001, adjusted for clustering). In addition, there was a statistically significant reduction in the frequency of inappropriate and potentially harmful practices per resuscitation in the trained group (trained 0.53 vs control 0.92; mean difference 0.40, [95% CI 0.13-0.66], p = 0.004).Implementation of a simple, one day newborn resuscitation training can be followed immediately by significant improvement in health workers' practices. However, evidence of the effects on long term performance or clinical outcomes can only be established by larger cluster randomised trials.Controlled-Trials.com ISRCTN92218092.http://europepmc.org/articles/PMC2229665?pdf=render
spellingShingle Newton Opiyo
Fred Were
Fridah Govedi
Greg Fegan
Aggrey Wasunna
Mike English
Effect of newborn resuscitation training on health worker practices in Pumwani Hospital, Kenya.
PLoS ONE
title Effect of newborn resuscitation training on health worker practices in Pumwani Hospital, Kenya.
title_full Effect of newborn resuscitation training on health worker practices in Pumwani Hospital, Kenya.
title_fullStr Effect of newborn resuscitation training on health worker practices in Pumwani Hospital, Kenya.
title_full_unstemmed Effect of newborn resuscitation training on health worker practices in Pumwani Hospital, Kenya.
title_short Effect of newborn resuscitation training on health worker practices in Pumwani Hospital, Kenya.
title_sort effect of newborn resuscitation training on health worker practices in pumwani hospital kenya
url http://europepmc.org/articles/PMC2229665?pdf=render
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