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Acta Paediatr. 2019 May;108(5):806-813. doi: 10.1111/apa.14706. Epub 2019 Jan 24.

Does the Helping Babies Breathe Programme impact on neonatal resuscitation care practices? Results from systematic review and meta-analysis.

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School of Public Health and Community Medicine, B.P Koirala Institute of Health Sciences, Dharan, Nepal.
Golden Community, Jawagal, Nepal.
International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.



This paper examines the change in neonatal resuscitation practices after the implementation of the Helping Babies Breathe (HBB) programme.


A systematic review was carried out on studies reporting the impact of HBB programmes among the literature found in Medline, POPLINE, LILACS, African Index Medicus, Cochrane, Web of Science and Index Medicus for the Eastern Mediterranean Region database. We selected clinical trials with randomised control, quasi-experimental and cross-sectional designs. We used a data extraction tool to extract information on intervention and outcome reporting. We carried out a meta-analysis of the extracted data on the neonatal resuscitation practices following HBB programme using Review Manager.


Four studies that reported on neonatal resuscitation practices before and after the implementation of the HBB programme were identified. The pooled results showed no changes in the use of stimulation (RR-0.54; 95% CI, 0.21-1.42), suctioning (RR-0.48; 95% CI, 0.18-1.27) and bag-and-mask ventilation (RR-0.93; 95% CI, 0.47-1.83) after HBB training. The proportion of babies receiving bag-and-mask ventilation within the Golden Minute of birth increased by more than 2.5 times (RR-2.67; 95% CI, 2.17-3.28).


The bag-and-mask ventilation within Golden minute has improved following the HBB programme. Implementation of HBB training improves timely initiation of bag-and-mask ventilation within one minute of birth.


Helping Babies Breathe; Low-and middle-income countries; Neonatal resuscitation; Ventilation within one minute of birth

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