'Helping babies breathe' training in sub-saharan Africa: educational impact and learner impressions

J Trop Pediatr. 2013 Jun;59(3):180-6. doi: 10.1093/tropej/fms077. Epub 2013 Jan 17.


Background: Poor resuscitation contributes significantly to neonatal deaths globally. Helping Babies Breathe (HBB) is a new evidence-based neonatal resuscitation curriculum for low-resource settings.

Objective: We sought to characterize knowledge changes after national-level HBB training in Ethiopia, factors correlated with successful training, resuscitation skills and trainees' perceptions.

Methods: Trainees completed multiple-choice questionnaires (MCQ) before and after a 2-day course. After training, bag-mask ventilation (BMV) skills were assessed and feedback questionnaires completed.

Results: Resuscitation knowledge improved from 8.7/10 (SD 1.4) to 9.4/10 (SD 1.1; p = 0.003). Correct MCQ responses relating to essential aspects of resuscitation increased 68-79%. Pre-training knowledge differences between physicians and non-physicians disappeared. MCQ scores increased as trainer:trainee ratio decreased (p = 0.004). Mean post-HBB BMV scores [5.7/7 (SD 1.6)] were not impacted by trainer:trainee ratio.

Conclusions: Ethiopian HBB training improved neonatal resuscitation knowledge and was well received. Lower trainer:trainee ratio was associated with increased MCQ scores. HBB eliminated baseline knowledge differences between Ethiopian healthworker cadres.

Keywords: developing countries; educational intervention; international child health; neonatal mortality; neonatal resuscitation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Clinical Competence*
  • Curriculum*
  • Educational Measurement
  • Ethiopia
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Personnel / education*
  • Humans
  • Infant
  • Interviews as Topic
  • Male
  • Qualitative Research
  • Resuscitation / education*
  • Surveys and Questionnaires