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Women Birth. 2018 May 21. pii: S1871-5192(17)30737-0. doi: 10.1016/j.wombi.2018.04.016. [Epub ahead of print]

Review of educational interventions to increase traditional birth attendants' neonatal resuscitation self-efficacy.

Author information

1
Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, United States. Electronic address: marvesh@bellsouth.net.
2
College of Nursing, Medical University of South Carolina, 99 Jonathan Lucas St, Charleston, SC 29425, United States.
3
Faculty of Nursing, Cumming School of Medicine, Department of Community Health Sciences, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada.
4
Ralph H. Johnson Veterans Affairs (VA) Medical Center, 1'09 Bee Street, Charleston, SC, 20401, United States; Department of Pediatrics, College of Medicine, Medical University of South Carolina, 135 Rutledge Avenue, Charleston, SC, 29425, United States.

Abstract

BACKGROUND:

Annually, up to 2.7 million neonatal deaths occur worldwide, and 25% of these deaths are caused by birth asphyxia. Infants born in rural areas of low-and-middle-income countries are often delivered by traditional birth attendants and have a greater risk of birth asphyxia-related mortality.

AIM:

This review will evaluate the effectiveness of neonatal resuscitation educational interventions in improving traditional birth attendants' knowledge, perceived self-efficacy, and infant mortality outcomes in low-and-middle-income countries.

METHODS:

An integrative review was conducted to identify studies pertaining to neonatal resuscitation training of traditional birth attendants and midwives for home-based births in low-and-middle-income countries. Ten studies met inclusion criteria.

FINDINGS:

Most interventions were based on the American Association of Pediatrics Neonatal Resuscitation Program, World Health Organization Safe Motherhood Guidelines and American College of Nurse-Midwives Life Saving Skills protocols. Three studies exclusively for traditional birth attendants reported decreases in neonatal mortality rates ranging from 22% to 65%. These studies utilized pictorial and oral forms of teaching, consistent in addressing the social cognitive theory. Studies employing skill demonstration, role-play, and pictorial charts showed increased pre- to post-knowledge scores and high self-efficacy scores. In two studies, a team approach, where traditional birth attendants were assisted, was reported to decrease neonatal mortality rate from 49-43/1000 births to 10.5-3.7/1000 births.

CONCLUSION:

Culturally appropriate methods, such as role-play, demonstration, and pictorial charts, can contribute to increased knowledge and self-efficacy related to neonatal resuscitation. A team approach to training traditional birth attendants, assisted by village health workers during home-based childbirths may reduce neonatal mortality rates.

KEYWORDS:

Low-and-middle-income countries; Neonatal resuscitation; Self-efficacy; Traditional birth attendants; Training

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