A Study on Educational Intervention Study Published

Helping Babies Breathe (HBB) is a simulation-based educational program developed to help reduce perinatal mortality worldwide. A one-day HBB training course did not improve clinical management of neonates. The objective was to assess the impact of frequent brief (3–5 min weekly) onsite HBB simulation training on newborn resuscitation practices in the delivery room and the potential impact on 24-h neonatal mortality. The results showed that on-site, brief and frequent HBB simulation training appears to facilitate transfer of new
knowledge and skills into clinical practice and to be accompanied by a decrease in neonatal mortality. Read the full publication here.

Dr. Jørgen Linde Presents at Norwegian Research Competition

Dr. Jørgen E. Linde, one of the Safer Births PhD fellows, presented his research project at the “Forsker Grand Prix,” the national championship competition for researchers in Norway.

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Jørgen’s presentation “When life is a breath away” was nominated by the audience and the jury as the winner from the Stavanger Region, leading him to represent his work at the final competition in Bergen this fall.  Linde’s presentation included his findings on how his study showed that giving higher volumes when ventilating than the guidelines recommend produces better outcomes.  He also spoke about the importance of using heart rate as a form of feedback during ventilation and various techniques that can be used to optimize bag and mask ventilation.  The judges gave Jørgen’s presentation the top score, and emphasized how important they felt his research was.

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Haydom Begins RCT on Upright w/ PEEP

Haydom Hospital has recently begun a randomized control trial (RCT) comparing the Upright bag-mask with and without PEEP (positive end-expiratory pressure). PEEP is considered to benefit newborn and small infants by preventing repeated lung alveolar collapse, helping recruit lung volume more efficiently, clearing fluid from the lungs and reducing damage to the lung tissue during ventilation. The international Liaison Committee on Resuscitation (ILCOR) suggests using PEEP for preterm infants during delivery room resuscitation. However, ILCOR is unable to make any recommendation for term infants due to insufficient data. The RCT in Tanzania will be helpful in providing the data needed to support use of PEEP in order to improve newborn ventilation.

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Positive Results on Training in Neonatal Ventilation with PEEP

Dr. Monica Thallinger’s work using Upright with Newborn PEEP was recently published in the British Medical Journal. Positive end expiratory pressure (PEEP) is considered to be beneficial when ventilating preterm newborns. The aim of Thallinger’s study was to determine whether inexperienced providers were able to generate PEEP during simulated neonatal ventilation. Her study showed that inexperienced participants were successfully able to generate PEEP with a novel silicone PEEP valve attached to an upright self-inflating bag, without an external gas source. Read the full publication here.

Safer Births researchers presenting FIGO 2015

More and more research is coming out of the datas collected at Haydom and Muhibili. There is a much interest in the study and the results,  so 2015 has been a busy year for the researchers.This week at one of the largest medical conferences in the world the World Congress of Gynaecology and Obstetrics FIGO 2015 in Vancouver Canada, two of the Safer Births PhD Fellows are giving oral presentations on their recent findings. 

The room was completely full yesterday 6th october when Dr. Paschal Mdoe presented the preliminary results from the Randomized controlled study comparing hand held doppler and Pinard Fetoscope for fetal heart rate monitoring in Tanzania.

It was fascinating to hear that the results from the rural hospital Haydom Lutheran Hospital and the Urban hospital Muhimbili National Hopital were different and it will be interesting to learn more about why in the final analysis and futur studies.

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On Thursday morning 8th October Dr. Jørgen Linde will do a presentation called Heart Rate detection in “Fresh stillbirths” and Early Neonatal Deaths during Resuscitation – What is the true stillbirth rate?

This study is based on the data collected with the newborn resucitation monitor using dry electrodes on the abdomen of the newborn to detect the heart rate immediately after birth.

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But this is not the first conference this year where the Safer Births Researchers have been active.

In March at the 9th Annual Global Health and Vaccination Research Conference (GLOBVAC) in Oslo the Safer Births group had five poster and one oral presentation. Then at the high-light of the year, The Pediatric Academic Society (PAS) in San Diego, there were also five poster presentations from the group

  • Randomized controlled study comparing handheld Doppler and Pinard Fetoscope for fetal heart rate monitoring in Tanzania. Mdoe P, Mduma E, Ersdal H, Moshiro R, Perlman J, Kidanto H. Presented PAS 2015
  • CUSUM statistical process control method can be used to continuously monitor the impact of health interventions and management on neonatal mortality rate. Mduma E, Ersdal H, Kvaløy J, Søreide E, Mdoe P, Perlman J, Kidanto H, Svensen E. Accepted PAS 2015 and Globvac 2015.
  • Novel resuscitation bag and mask provide PEEP in a newborn manikin. Thallinger M, Ersdal H, Purington C, Gomo Ø, Eilevstjønn J, Morley C, Størdal K. Presented PAS 2015 and Globvac 2015.
  • Novel newborn resuscitator gives significantly less mask leakage on a manikin model. Thallinger M, Ersdal H, Størdal K. Presented PAS 2015 and Globvac 2015.
  • Neonatal heart rate in the first minutes of life measured with novel dry electrodes heart rate measurement technology. Linde JE, Eilevstjønn J, Francis F, Perlman J, Ersdal HL. Presented PAS and Globvac 2015.
  • Quality of Partogram recordings and perinatal outcomes at Muhimbili National Hospital Tanzania. Mdoe P, Masawe S, Kidanto H, Mduma E, Ersdal H. Presented Globvac 2015

Not to mention that during the Norwegian Researchers Grand Prix, Huyen Vu and Dr. Monica Thallinger were participating and Dr. Thalling got all the way to the finals presenting her randomized study on the Upright Bag and Mask vs. Simplified Resuscitator.

 

Safer Births Meeting in Stavanger

fb2How can newborn ventilation be improved? The Safer Births partnership, a collaboration of midwives, doctors, researchers and developers from Tanzania and Norway, believes the key to improvement is with frequent training. From March 18 to 20, 2015, key stakeholders gathered in Stavanger to discuss training concepts, real life experiences, equipment opportunities, and recent research, all related to newborn ventilation.  Through workshops and case studies, it was concluded that the 4 key areas of improvement during newborn resuscitation are: prioritizing tasks, team work and collaboration, decision making, and skill training.  Moving forwards, the group in Norway will follow up with providing sustainable training solutions that the group returning to Tanzania can effectively implement.

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On Wednesday, 5 midwives and 1 researched produced a ventilation training instruction video which was filmed in the Laerdal film studio. The purpose was not to make a final instruction video for educational use, but to see if this would be embraced as a useful teaching tool. The video was presented on Thursday to all meeting participants, and general opinion was that this could be a very good tool in a ventilation training setting, especially because the content and quality of instructions would be standardized for all students, and independent of different instructor’s different skills.

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Many different equipment and training combinations were evaluated by the midwives and doctors.  Overall, they prioritized having training equipment that was adjustable for different levels of difficulty and that gave feedback to the user based on performance.  It was also important  that it could be used in a realistic scenario, including movement of the manikin from bedside at birth to the resuscitation table.

2nd Safer Births Annual Meeting

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The second Safer Births annual meeting is being held in Haydom Lutheran Hospital on the 1-5th of October 2014. Over 20 researchers, developers and health workers are gathering in Haydom to go through the progress of the Safer Births project in the last year.

The 6 PhD candidates in the project are now fully working on their PhD projects and several has already presented their findings at international conferences, and their research and progress will also be presented at the meeting.

Important events in the last year is amongst others winning the Saving Lives at Birth Grand Challenge nomination, and being able to expand the project to also test MOYO- Fetal Heart Rate Monitor in referral institutions and Antenatal care clinics. And the MOYO partners will also be meeting in Haydom in these days to discuss the implementation of the program.

After the annual meeting representatives from the research council and the GLOBVAC board will be doing a site visit at Haydom on the 6th of Oct.

 

MOYO – Winner of Saving Lives at Birth Grand Challenge

MOYO article

Out of 500 applications, the  MOYO- Improved Fetal Heart Rate Monitoring for Safer Births project, was one of 30 award nominees for the Saving Lives at Birth (SLAB) Grand Challenge. This was announced at the DevelopmentXChange 2014 in Washington on 1 August.

 

MOYO-Improved Fetal Heart Rate Monitoring for Safer Births

The MOYO SLAB project will contDongobesh motherribute to the development of Laerdal’a Fetal Heart Rate Monitor Moyo, and an adapted simulation based training program for timely and improved obstetric responses. It will also pilot test Moyo in labor wards and antenatal care in four sites in Tanzania. The two urban sites are Temeke District Hospital and Muhimbili National Hospital in Dar Es Salaam, while the rural sites are Haydom Lutheran Hospital and Dongobesh Health Center in Northern Tanzania. Muhimbili and Haydom are both large referral hospitale, while Temeke and Dongobesh are referring the complicated cases to the two others.

The hypothesis of the project is that Moyo bundled with timely obstetric responses will reduce the burden of stillbirth and birth asphyxia. We also think that if we expand the use of MOYO to referring hospitals and dispensaries will improve referrals, and finally that training ante natal care nurses and using MOYO in ante natal visits, will build trust with the nurses who will encourage mothers to deliver in safe environments.

By implementing this new device and training, we expect to see earlier detection and diagnosis of abnormal FHR at all 4 sites and an increase in timely referrals from the 2 referring sites. Our hypothesis is that earlier detection of fetuses at risk and timely obstetric responses can lead to a 30-40 % reduction in fresh stillbirths and birth asphyxia.

Saving Lives at Birth Round 4. SLAB- Helge

The Saving Lives at Birth partnership, launched in 2011, includes the U.S. Agency for International Development (USAID), the Government of Norway, the Bill & Melinda Gates Foundation, Grand Challenges Canada (funded by the Government of Canada), and the U.K’s Department for International Development (DFID). This year was the fourth time the grant was announced and 52 projects were selected as finalists. All finalists, including Laerdal Global Health, were participating at the DevelopmentXChange, displaying their projects. Laerdal Global Health will now enter into final negotiations before awards are issued.

Read the full press release from Saving Lives at Birth here.

For more information, see the Saving Lives at Birth website.

Finalist at the Saving Lives at Birth Grand Challenge

MOYO article
Amongst 500 applicants Laerdal Global Health’s Fetal Heart Rate Monitor MOYO has been selected as one of 52 finalists in the Saving Lives at Birth (SLAB) Grand Challenge taking place in Washington this month.
The highly prestigious SLAB Grand Challenge is a cooperation between USAID, the Bill & Melinda Gates Foundation, DFID and the Government of Norway and Canada, funding groundbreaking innovations aiming at helping mothers and newborns around the time of delivery.
LGH is seeking funding for further development and pilot testing of MOYO with an adapted simulation training program in three hospitals and one health center in rural and urban Tanzania. By implementing this new device and training we expect to see earlier detection and diagnosis of abnormal FHR at all 4 sites and an increase in timely referrals from the 2 referring sites. Our hypothesis is that earlier detection of fetuses at risk and timely obstetric responses can lead to a 30-40 % reduction in fresh stillbirths and birth asphyxia.
Take a few minutes, and vote for MOYO and/or other projects that you think deserve to win the People’s Choice Award here