University of Calgary

Low-cost program slashes newborn deaths in India by 30%

UToday HomeJuly 3, 2013

By Marta Cyperling

Dr. Nalini Singhal (far right) works with Helping Babies Breathe trainers in October 2011. Photo courtesy HBBDr. Nalini Singhal (far right) works with Helping Babies Breathe trainers in October 2011. Photo courtesy HBBIn India and other developing countries, infant mortality remains an everyday occurrence. Some countries will not meet the UN’s Millennium Development Goal of reducing infant mortality by two-thirds by 2015. There are about 2.6 million stillbirths and 3.1 million neonatal deaths annually – in the world.

Seeking a low-cost, effective way to reduce newborn deaths related to asphyxia in resource limited areas, the American Academy of Pediatrics developed the Helping Babies Breathe (HBB) program in 2010.

HBB is an evidence-based, simple educational program to teach neonatal resuscitation techniques to local health-care providers including doctors, nurses, and midwives. It includes a low-cost neonatal simulator to practice bag and mask ventilation.

Dr. Nalini Singhal, a professor at the University of Calgary and the associate editor of HBB, with the help of Dr. Jocelyn Lockyer, senior associate dean of education at the University of Calgary, carried out a formative educational evaluation to see how the program improved skills and knowledge. The program was modified based on results of the beta testing. Two years after the start of HBB, researchers evaluated its effectiveness and found that infant mortality dropped 30 per cent in areas of India where it was used.

“Newborn resuscitation can be taught and the provider skills can be maintained. Every baby deserves a chance no matter where they are born,” says Singhal, who is also a member of the university’s Alberta Children’s Hospital Research Institute and principal author of the study that appeared in the January 2013 edition of the journal Pediatrics.

A key aspect of the program is the Golden Minute, which specifies that a baby should either be breathing spontaneously, or have artificially supported breathing, within one minute of birth.

HBB provides practical steps for health-care providers to use to evaluate and rectify breathing problems and is now being implemented in more than 50 countries.