WIP 64 - Impact of the World Health Organizations' Essential Newborn Care (ENC) training on quality of neonatal resuscitations in a low-resource urban setting

Poster Number: WIP 64
Publication Number: WIP 64.928

Background: Helping Babies Breathe (HBB) methodology, coupled with quality improvement (QI) strategies, has been shown to decrease neonatal mortality (Kamath-Rayne 2018, J. Perinatology). Still, many factors challenge persistent improvement in outcomes after HBB training, including equipment availability, limited staffing with high turnover, and skill loss (Morris 2020, Pediatrics). The World Health Organization’s Essential Newborn Care 1 (ENC 1) training, which utilizes HBB learning methodology, focuses on optimizing newborn care through the first 60 minutes of life. ENC Now!, developed by the American Academy of Pediatrics and Laerdal Global Health and available at hmbs.org, is a digital training platform for ENC 1 designed to accommodate remote facilitation to address the hurdle of accessibility.

Objective: 1. Utilize video-taped resuscitations to assess the impact of ENC Now! training on resuscitation skills.
2. Evaluate the impact of ENC Now! training on neonatal outcomes immediately following delivery.

Design/Methods: We designed a prospective cohort study to evaluate the effectiveness of ENC Now! training. Fifty-nine nurse-midwives working at 4 municipal clinics in urban Harare, Zimbabwe participated in this study and were filmed performing neonatal resuscitations over two 6-month epochs, prior to and after receiving ENC Now! training. Training was conducted remotely by trained facilitators. A convenience sample of pregnant parents presenting for term-singleton deliveries were consented for filming of delivery and newborn resuscitation from October 2021 to November 2022. A total of 488 resuscitations were filmed and are now being scored by four epoch-blinded reviewers utilizing a common scoring form to assess for adherence to recommended ENC 1 practices. STATA/SE 18.0 will be used to perform aggregated data analysis. After completion of resuscitation scoring, we anticipate final data analysis comparing the two cohorts prior to April 2024. IRB and ethics approvals were obtained from the American Academy of Pediatrics and the Medical Research Council of Zimbabwe.