Helping Babies Breathe

I know that I have written about this organzation before but so worth checking out if you are interested in infant health and survival.  Website: http://www.helpingbabiesbreathe.org/

Objective of HBB

To ensure that all babies are born with a skilled birth attendant present.

The Curriculum

Helping Babies Breathe is a neonatal resuscitation curriculum for resource-limited circumstances. It was developed on the premise that assessment at birth and simple newborn care are things that every baby deserves. The initial steps taught in HBB can save lives and give a much better start to many babies who struggle to breathe at birth. The focus is to meet the needs of every baby born.

The Golden Minute®

Helping Babies Breathe emphasizes skilled attendance at birth, assessment of every baby, temperature support, stimulation to breathe, and assisted ventilation as needed, all within “The Golden Minute” after birth.

Preventing Under Five Mortality

When I was working on the Thai-Burma border, there was a group bringing backpacks full of medical supplies.  So when I saw this interview on under 5 mortality between Andrea Mitchell of MSNBC and USAID Administrator Raj Shah, I thought it was worth sharing.

Cheap solutions to prevent 7mn under 5 deaths, including:

Diarrhea vaccine

Sweet potatoes — has Beta Karo-tine for vitamin A

Zinc tablets — for diarrhea and used with deydration salts

Bed nets — 220,000 children saved each year — cost $6

Mask to help new babies breathe

Study Low Birth Weight Babies in Lao PDR

This study (Nagoya J. Med. Sci.  72. 51 ~ 58, 2010) shows that mother’s health and nutrition are factors in babies being born with low birth rates.

Mothers who demonstrated a good grasp of nutrition and health delivered LBW infants 10.1 less frequently than mothers who showed more limited knowledge…

While considering the health status of mothers, it was found that those in poor health had LBW infants 3.4 times more often than healthy mothers.

Other issues like family support also play a role:

…In the traditional society of Lao PDR, women have little independence to decide their own future. For a pregnant mother to get medical support, she must wait for the decision of her husband or other family members before consulting a medical doctor for a check-up of her pregnancy status. The necessity of a nutritious diet and the extent of its availability is, except in some rare situations, again dependent on the wishes of the family.

“Hypertension and proteinuria leading to pre-eclampsia” was found in the study to be the cause of 20-25% of prenatal mortalities.

Conclusions:

The results of this study showed that the maternal factors significantly associated with LBW infants included the mother’s age and occupation, her knowledge and health status, and the family’s income. It may not be possible to address all these issues at once, but early and regular antenatal visits by prospective mothers and conducting awareness programs through the mass
media focusing on proper care during pregnancy could alleviate many of these problems.

Countdown to 2015 report: Look at Laos

Countdown to 2015 released country profiles today.

The 2012 Report, Building a Future for Women and Children, highlights country progress—and obstacles to progress—towards achieving Millennium Development Goals 4 and 5 to reduce child mortality and improve maternal health.

Lao PDR is a mixed bag.  Significant progress has been made in water and sanitation, malaria prevention, and immunizations. However there is much, much more to be done. Two biggies that I see: only 26% of infants <6 are exclusively breastfed (up from 23% in 2000) and only 20% of births have a skilled attendant (up from 19% in 2000).  Antenatal care is still bleak — with 35% attended once in pregancy by a provider — up from 27% in 2000.  Density of doctors, nurses and midwives stands at 12.4 per 10,000 population.

My summary: keep funding clean birth kits, community health workers and midwifery training.

Simple Checklist to Prevent Maternal/Infant Deaths

Acording to this article from Impact, http://www.psi.org/impact-magazine/2012/05/can-simple-checklist-make-child-birth-safer, checklists have cut surgical deaths in half.  Makes alot of sense for birth.

PSI/India has joined a team led by the World Health Organization, Harvard School of Public Health, Bill & Melinda Gates Foundation and many others who are asking whether checklists can significantly reduce the nearly 5 million maternal and infant deaths a year associated with childbirth.

PSI/India and partners have assembled a 31-item list of reminders, from the simple – asking the mother’s companion to be present at the birth – to precise clinical signs of infection and hemorrhage. Their aim over the next three years is to test it in India to see whether childbirth-related harm, including death, in institutional deliveries can be significantly reduced through adherence to essential childbirth-related clinical care standards.

Helping Babies Breathe Initiative

The more I learn about clean birth kits and their usage, the more I understand how trained attendants are critical to the survival of moms and babies.

One amazing program that I have learned of is Helping Babies Breath.  This program trains midwifes, doctors,  nurses, and “in certain circumstances” traditional birth attendants in  neonatal resuscitation.  Here’s more:

The Curriculum

Helping Babies Breathe is a neonatal resuscitation curriculum for resource-limited circumstances. It was developed on the premise that assessment at birth and simple newborn care are things that every baby deserves. The initial steps taught in HBB can save lives and give a much better start to many babies who struggle to breathe at birth. The focus is to meet the needs of every baby born.

The Golden Minute®

Helping Babies Breathe emphasizes skilled attendance at birth, assessment of every baby, temperature support, stimulation to breathe, and assisted ventilation as needed, all within “The Golden Minute” after birth.

This article from USAID on The Golden Minute® is also worth a read.

 To reach five years, though, a child must take his or her first breath of life in the first minute following birth. The World Health Organization estimates approximately one million babies die each year from birth asphyxia, a condition in which babies who do not breathe on their own immediately following delivery.

“Midwives Matter for Maternal Health and More”

Great post from NotEnoughGood.com (http://notenoughgood.com/2012/04/midwives/).

Midwives are undervalued and overlooked throughout the world.  They could make a difference to maternal and infant health outcomes.  According to the article:

UNFPA outlines the many skills a professional midwife can offer in reducing maternal mortality and morbidity.  For example, before and during pregnancy, midwives can be a source of substantiated advice and information. They can be a source of family planning advice and materials. During pregnancy and labor, a trained midwife can recognize signs of problems in women and their newborns, and can refer a woman to the appropriate facility.  When adequately trained, midwives can also provide emergency care. Through these skills, UNFPA believes that midwives can play a key role in achieving MDGs 4 (reduce child mortality), 5 (improve maternal health) and 6 (combat HIV/AIDS, malaria and other diseases). In some countries, midwives can also provide vaccination services.

The article goes on to talk about success stories in countries that  ”have harnessed the power of midwives as frontline maternal health workers”.  Malaysia was able to reduce maternal mortality in this way.

The article concludes:

Investment in midwives, who are part of their communities and able to provide culturally relevant but accurate information is an invaluable resource for many women who would otherwise go without such quality care.  Because qualified midwives are trained to understand infectious disease and issues in the scope of pre- and post-natal care, as well as delivery, they are important assets to countries seeking to improve the lives of women, children, and other vulnerable populations.

Save the Children in Laos

Save the Children’s Laos Health Program has had great success in the area of the country that they have been serving for 20 years.  They have seen an 80% drop in maternal and infant mortality compared with the whole of Laos.  But by their own admission there is a long way to go:

The health situation of women and children in Laos is amongst the poorest in Southeast Asia; Infant mortality rate is 70 per 1000 live births and under five mortality claims 98 per 1000 live births1.  Every day 36 children under-five die due to preventable and treatable diseases. Percentages of underweight children have been almost unchanged between 1990 and 2006 (40% and 37.1%) and the prevalence of stunting in under-fives is up to 40.4%. According to UNICEF/WHO official estimate (2007), immunisation coverage has declined—only 27% of children by their first birthday have received all eight recommended vaccinations2.  Maternal mortality remains very high at 405/100,000 live births, approximately 800 deaths per year or 2 deaths per day. A high percentage of children (71.5%) are born to mothers who received no antenatal care and 84.8% of pregnant women give birth at home3 . These are clear indicators of low health service utilization and poor quality health services/facilities.

Reduced Food Rations on Thai-Burma Border, Moms/Kids at Risk

Ugh…this makes me sad and makes me wonder what I can do to help.  The Mae Tao Clinic where I volunteered from Oct ’09-Feb ’10 is cutting food rations, in line with spending cuts by NGOs along the Thai-Burma border.  This article   finds that NGO money is leaving Thailand for inside Burma, resulting in smaller food rations and increased cases of malnutrition.

…The Thai Burma Border Consortium (TBBC), which coordinates NGO activity in the camps, has already been forced to downsize food rations for refugees to two thirds of the recommended nutritional intake, leaving children, pregnant and breast-feeding women at particular risk.

…With over 600 staff members, the Mae Tao clinic treats up to 300 patients daily and feeds more than 500 people.

…According to TBBC as many as 150,000 refugees live along the Thai border. About 30,000 of them are children.

5 Innovations to Save Moms

I am excited about this article, “Five Maternal Health Innovations That Could Save Lives on the PBS Newshour site.  Check it out for full details of each project.  I love, love, love seeing these innovative, simple solutions.

Here is the list of 5 and short descritptions:

1.  Preventing low birth weight with chewing gum

Baylor College of Medicine in Houston, Texas

…Some chewing gums contain sugar alcohols, called polyols, that prevent gum disease2…

2.  Stopping HIV transmission with a vacuum pack 

Duke University from Durham, N.C.

…Duke University developed a foil, polyethylene pouch — much like a fast-food ketchup pouch — that can store medicine for months so that ARVs can be administered as soon as a child is born…

3.  Mobile heart monitoring and data gathering
Save the Children Federation from Westport, Conn.

—A mobile fetal heart rate monitor powered by human energy, which won a 2009 Index award, and a mobile phone based data gathering platform will be tested together to improve monitoring…

4.  An innovative alternative to forceps
The World Health Organization in Geneva, Switzerland

…The devices is a film-like polyethylene material that looks like an open plastic bag wrapped around the head of the baby, sealed and used to help extraction during complications…

5. Diagnosing with paper stamps
Diagnostics for All, Inc. from Cambridge, Mass.

…Diagnostics for All will create two postage stamp-sized paper tools that can detect anemia and hypoglycemia and hypertensive disorders, all indicators of high-risk pregnancy…