School of Public Health
Impact Assessment of a Simulation-Based Educational Program in Neonatal and Maternal Resuscitation in the Philippines
Reduction in maternal (MMR) and neonatal mortality rates (NMR) remains challenging in limited-resource settings (LRS) and achievement of the United Nations Sustainable Development Goal (SDG) 3 remains a distant reality for many developing countries. Philippines has some of the highest MMR and NMR in Southeast Asia. Helping Babies Breathe (HBB) is a simulation-based educational program designed to address neonatal asphyxia during resuscitation of infants and is targeted specifically toward birth attendants in LRS. Helping Mothers Survive (HMS) is a similar platform to address knowledge and skill development in postpartum hemorrhage management, the primary cause of perinatal morbidity and mortality. This project will disseminate and assess the impact of integrated simulation training in HBB and HMS programs on NMR and MMR.
This project includes four main aims:
Firstly, to conduct a formal needs assessment to clearly identify opportunities and barriers to project implementation which will inform development of strategies for adapting the curriculum to remote regions where out of hospital birth is more common. This aim has largely already been accomplished/completed by our project team over the past 24 months.
Secondly, to establish a local trainer cohort within the Philippines to disseminate integrated educational programs in neonatal and obstetric emergency management in a train-the-trainer cascade fashion. Our project group has completed Phase 1 of local training in the Philippines over the past 24 months and will continue with dissemination of training locally into more rural areas of the region during 2019, with some continued courses being taught and overseen by the project team in summer of 2019 in collaboration with a GHEFP student on site.
Thirdly, to evaluate the preliminary effectiveness of an integrated simulation curriculum and its translation to the clinical environment in district hospitals and birthing clinics, which will be assessed by changes in the quality of delivery room resuscitations and adherence to established algorithms for appropriate resuscitation of both infants and delivering mothers. This will be one focus of ongoing work in summer 2019 in more rural birthing centers within Davao Oriental as part of a larger program evaluation framework.
Lastly, to identify the necessary frequency "just-in-time" refresher training intervals necessary to promote sustainability of the curriculum that accounts for potential knowledge and skill decay over time. Work on this aim has already started and is ongoing. GHEFP students would potentially be involved in teaching and monitoring refresher trainings in the region of study as part of a larger program evaluation process.
PI Mentor: Nicole Shilkofski