ReviewFrom the Neonatal Resuscitation Program to Helping Babies Breathe: Global impact of educational programs in neonatal resuscitation
Introduction
The birth of a baby represents one of the most dramatic physiologic transitions in human life. Although this transition most often proceeds naturally and smoothly, the day of birth also carries high risk of death when the transition is disrupted. Neonatal resuscitation, broadly defined as support for successful transition at birth, thus has been a major focus in all efforts to improve neonatal survival. Even in technologically advanced settings, the now-accepted standard of having a person skilled in neonatal resuscitation at every birth took decades to become reality. In resource-limited settings this reality has not yet been achieved. Two educational programs for health care providers, the Neonatal Resuscitation Program (NRP) and Helping Babies Breathe (HBB), have played a central role in the evolution toward the global goal of having a skilled person present at the birth of every baby.
Section snippets
Elements promoting transportability
Development of NRP came in response to the emergence of neonatal intensive care in the 1970s. At that time, rates of neonatal mortality from asphyxia (intrapartum-related events) and prematurity were unacceptably high in the USA; there was increasing awareness that community hospitals needed to recognize and provide initial management of infants who required care in a neonatal intensive care unit. The National Institutes of Health funded five projects to provide education on the fundamentals of
Evolution of the approach to neonatal resuscitation: the origins of HBB
Nearly twenty years after the introduction of NRP, it became evident that a different approach was needed to address the global burden of neonatal mortality. In the year 2000 the United Nations General Assembly ratified the Millennium Development Goals (MDGs), aimed at reducing poverty globally. Among these, MDGs 4 and 5 dealt with reducing under-five child mortality and maternal mortality. MDG 4 focused the world's attention on just how large a proportion of under-five child deaths occurred in
Dissemination of HBB through the Global Development Alliance
Helping Babies Breathe was released in June 2010, simultaneous with the inauguration of the Helping Babies Breathe Global Development Alliance (GDA). In contrast with the spontaneous global dissemination of NRP, a public–private partnership among key organizations in the sphere of child health deliberately accelerated the dissemination of HBB in the face of the 2015 MDG 4 target. Founding partners of the GDA included the US Agency for International Development (USAID), the American Academy of
Role of NRP and HBB beyond the MDGs
The Neonatal Resuscitation Program and Helping Babies Breathe are educational programs that improve newborn survival in complementary ways. Both programs strive to translate global neonatal resuscitation guidelines into practice with simplicity and clarity, but at different levels of the health system. In first-level facilities HBB equips frontline providers with basic skills and brings the possibility of an attended birth to the furthest reaches of communities. When resources are available,
Conflict of interest statement
The author is editor of Helping Babies Breathe and a technical and editorial consultant for the American Academy of Pediatrics.
Funding sources
None.
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Neonatal resuscitation from a global perspective
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