[net-gold] COUNTRIES DEVELOPING COUNTRIES UNDERDEVELOPED AND LESSER DEVELOPED : MEDICAL: PREGNANCY AND CHILDBIRTH: STILLBIRTHS : HEALTH: EDUCATION AND INFORMATION: Stillbirths Drop Dramatically after Newborn-Care Training in Developing Countries
- From: "David P. Dillard" <jwne@xxxxxxxxxx>
- To: Net-Gold <Net-Gold@xxxxxxxxxxxxxxx>, Temple University Net-Gold Archive <net-gold@xxxxxxxxxxxxxxxxxxx>, Temple Gold Discussion Group <TEMPLE-GOLD@xxxxxxxxxxxxxxxxxxx>, Net-Gold <net-gold@xxxxxxxxxxxxxxxx>, Sean Grigsby <myarchives1@xxxxxxxxxxxxxxx>, Educator Gold <Educator-Gold@xxxxxxxxxxxxxxx>, Educator Gold <Educator-Gold@xxxxxxxxxxxxxxxx>, K12AdminLIFE <K12AdminLIFE@xxxxxxxxxxxxxxx>, Net-Platinum <net-platinum@xxxxxxxxxxxxxxx>, NetGold <netgold@xxxxxxxxxxxxxxx>, "Net-Gold @ Nabble" <ml-node+3172864-337556105@xxxxxxxxxxxxx>, K-12ADMINLIFE <K12ADMIN@xxxxxxxxxxxxxxxxxxx>, MediaMentor <mediamentor@xxxxxxxxxxxxxxx>, Digital Divide Diversity MLS <mls-digitaldivide@xxxxxxxxxxxxxxx>, net-gold@xxxxxxxxxxxxx
- Date: Sun, 21 Feb 2010 05:31:33 -0500 (EST)
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COUNTRIES DEVELOPING COUNTRIES UNDERDEVELOPED AND LESSER DEVELOPED :
MEDICAL: PREGNANCY AND CHILDBIRTH: STILLBIRTHS :
HEALTH: EDUCATION AND INFORMATION:
Stillbirths Drop Dramatically after
Newborn-Care Training in Developing Countries
Date: Thu, 18 Feb 2010 09:24:57 -0500
From: "NIH OLIB (NIH/OD)" <olib@xxxxxxxxxx>
To: NIHPRESS@xxxxxxxxxxxx
Subject: Stillbirths Drop Dramatically after
Newborn-Care Training in Developing Countries
U.S. Department of Health and Human Services
NATIONAL INSTITUTES OF HEALTH NIH News
Eunice Kennedy Shriver National Institute of Child Health and Human Development
(NICHD)
<http://www.nichd.nih.gov/>
Embargoed for Release: Wednesday, February 17, 2010, 5 p.m. EST
CONTACTS:
Robert Bock
or
Marianne Glass Miller
301-496-5133
e-mail:
bockr@xxxxxxxxxxxx
STILLBIRTHS DROP DRAMATICALLY AFTER
NEWBORN-CARE TRAINING IN DEVELOPING COUNTRIES
The rate of stillbirths in rural areas of six developing countries fell
more than 30 percent following a basic training program in newborn care
for birth attendants, according to a study funded by the National
Institutes of Health and the Bill and Melinda Gates Foundation. The study
tracked more than 120,000 births.
The study tested the efficacy of a three-day Essential Newborn Care
training regimen that covers basic newborn care techniques, the importance
of early breastfeeding, how to keep infants warm and dry, and signs of
serious health problems.
The study, the largest of its kind, is one of the first to track the rate
of infant deaths following the implementation of such a regimen. The World
Health Organization (WHO) estimates that, in addition to more than 3
million stillbirths worldwide each year, nearly 4 million infants die in
their first month of life.
<http://whqlibdoc.who.int/publications/2006/9241563206_eng.pdf>
The results appear in the Feb. 21 issue of The New England Journal of
Medicine.
"These findings suggest that a low-cost instructional regimen for birth
attendants can be effective in reducing stillbirths in parts of the world
where most births are not attended by a physician," said Alan E.
Guttmacher, M.D., acting director of the Eunice Kennedy Shriver National
Institute of Child Health and Human Development (NICHD), the NIH
institute, that, along with the Bill and Melinda Gates Foundation, funded
the study.
The research was conducted at study sites in Argentina, the Democratic
Republic of Congo, Guatemala, India, Pakistan, and Zambia as part of the
Global Network for Women's and Children's Health Research. The network is
a partnership of the NICHD and the Bill and Melinda Gates Foundation.
Waldemar A. Carlo, M.D., of the University of Alabama at Birmingham, led
the research team. The study's senior author was Linda L. Wright, M.D.,
scientific director of the NICHD Global Network for Women's and Children's
Health Research
<http://www.nichd.nih.gov/research/supported/globalnetwork.cfm>
Before data collection on births began, research staff taught local health
care workers how to collect data, assess infant health, and diagnose
stillbirth and other conditions. In addition, the researchers provided
local health care workers with scales to accurately measure birth weight,
hand-held pumps and masks to fill babies' lungs with air, and
clean-delivery kits to prevent infection.
One health care worker from each of the participating countries traveled
to the United States to learn essential newborn care techniques. That
person returned home to train other trainers, with the training ultimately
reaching 3,600 health care workers in rural communities -- physicians,
nurses, midwives, and birth attendants with no formal training.
Coordinators and attendants collected data on the births in their
communities. In 99.2 percent of cases, they also documented whether
babies were alive after one week. The researchers then compared statistics
before and after the emergency newborn care training.
The study authors found that the overall rate of infant death during the
first 7 days of life did not change among infants who had been
administered the essential newborn care regimen. However, the rate of
stillbirths dropped sharply -- from 23 per 1,000 deliveries to 15.9 per
1,000. The researchers believe these improvements were seen in infants who
had not drawn a breath on their own and would have been considered to have
been born dead by birth attendants who had not received the early newborn
care training.
"The reduction in stillbirth is extremely encouraging," Dr. Carlo said.
"Stillbirths among births attended by midwives and traditional birth
attendants declined to nearly the same levels seen among births attended
by physicians."
Dr. Carlo explained that many infants do not take a breath when they are
first born. In the majority of these cases, some kind of stimulation --
rubbing the back or tapping the soles of the feet -- will start the baby
breathing on its own. Other infants need air pushed into their lungs.
Birth attendants without training in recognizing and resuscitating
newborns who do not breathe at birth may consider the babies to be
stillborn and not attempt to revive them. The researchers found a decrease
in the rates of fresh stillbirth -- or death immediately before or at the
moment of birth. The study did not find a decrease in macerated
stillbirths-those assumed to have died before the beginning of labor.
The study authors concluded that the essential newborn care training was
most effective in providing attendants needed skills and expertise in
newborn resuscitation. The greatest decrease in stillbirth rates was among
deliveries attended by nurses, midwives, and traditional attendants, all
of whom, the researchers believe, would likely not have received such
training.
"Our results show that training in essential newborn care can play a role
in improving birth outcomes in the developing world," Dr. Wright said.
In a subsequent phase of the study, trainers led in-depth sessions focused
exclusively on neonatal resuscitation techniques in 88 randomly selected
communities, where attendants had already undergone the ENC program. The
researchers found this additional training did not further reduce infant
mortality from stillbirth or other causes.
The NICHD sponsors research on development, before and after birth;
maternal, child, and family health; reproductive biology and population
issues; and medical rehabilitation. For more information, visit the
Institute's Web site at
<http://www.nichd.nih.gov/>
The National Institutes of Health (NIH) -- The Nation's Medical Research
Agency -- includes 27 Institutes and Centers and is a component of the
U.S. Department of Health and Human Services. It is the primary federal
agency for conducting and supporting basic, clinical and translational
medical research, and it investigates the causes, treatments, and cures
for both common and rare diseases. For more information about NIH and its
programs, visit
<http://www.nih.gov>
##
This NIH News Release is available online at:
<http://www.nih.gov/news/health/feb2010/nichd-17.htm>
Sincerely,
David Dillard
Temple University
(215) 204 - 4584
jwne@xxxxxxxxxx
<http://daviddillard.businesscard2.com>
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