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Resuscitation. 2014 Feb;85(2):253-9. doi: 10.1016/j.resuscitation.2013.10.020. Epub 2013 Oct 29.

The impact of an intervention package promoting effective neonatal resuscitation training in rural China.

Author information

1
National Center for Women's and Children's Health China CDC, Beijing, PR China. Electronic address: xutao6622@163.com.
2
National Center for Women's and Children's Health China CDC, Beijing, PR China.
3
Peking University Third Hospital, PR China.
4
Tinghua University First Hospital, PR China.
5
Peking Union Medical College Hospital, PR China.
6
Beijing Maternity Hospital affiliated with Capital Medical University, PR China.
7
Peking University First Hospital, PR China.
8
Division of Neonatal and Developmental Medicine, Stanford University, USA.
9
Division of Neonatology, St. Christopher's Hospital for Children, USA.
10
National Center for Women's and Children's Health China CDC, Beijing, PR China. Electronic address: zt@chinawch.org.cn.

Abstract

OBJECTIVE:

To evaluate an intervention package promoting effective neonatal resuscitation training at county level hospitals across China.

METHODS:

The intervention package was implemented across 4 counties and included expert seminars, training workshops, establishment of hospital-based resuscitation teams, and supervision of training by national and provincial instructors. Upon completing the activities, a survey was conducted in all county hospitals in the 4 intervention counties and 4 randomly selected control counties. Data on healthcare providers' knowledge and self-confidence, and incidence of deaths from birth asphyxia from 2009 to 2011 in all hospitals were collected and compared between the two groups.

RESULTS:

Eleven intervention and eleven control hospitals participated in the evaluation, with 97 and 87 health providers, respectively, completing the questionnaire survey. Over 90% of intervention hospitals had implemented neonatal resuscitation related practice protocols, while in control hospitals the proportion was less than 55%. The average knowledge scores of health providers in the intervention and control counties taking a written exam were 9.2±1.2 and 8.4±1.5, respectively (P<0.001) out of maximum possible score of 10, and the average self-confidence scores were 57.3±2.5 and 54.1±8.2, respectively (P<0.001). Incidence of birth asphyxia (defined as 1-min Apgar score≤7) decreased from 8.8% to 6.0% (P<0.001) in the intervention counties, and asphyxia-related deaths in the delivery room decreased from 27.6 to 5.0 per 100,000 (P=0.076). There was no difference over time in asphyxia rates for the control counties.

CONCLUSIONS:

The intervention has not only improved skills of health providers, decreased the mortality and morbidity of birth asphyxia, but also resulted in effective implementation of guidelines and protocols within hospitals.

KEYWORDS:

Asphyxia neonatorum; China; In-service training; Intervention; Neonatal mortality; Resuscitation

[Indexed for MEDLINE]

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