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Training Zambian traditional birth attendants to reduce neonatal mortality in the Lufwanyama Neonatal Survival Project (LUNESP)

2012; Elsevier BV; Volume: 118; Issue: 1 Linguagem: Inglês

10.1016/j.ijgo.2012.02.012

1879-3479

Christopher Gill, Nicholas Guerina, Charity Mulenga, A Knapp, Grace Mazala, Davidson H. Hamer,

Maternal and Neonatal Healthcare

Abstract Objective To provide relevant details on how interventions in the Lufwanyama Neonatal Survival Project (LUNESP) were developed and how Zambian traditional birth attendants (TBAs) were trained to perform them. Methods The study tested 2 interventions: a simplified version of the American Academy of Pediatrics’ neonatal resuscitation protocol (NRP); and antibiotics with facilitated referral (AFR). Results Key elements that enabled the positive study result were: focusing on common and correctible causes of mortality; selecting a study population with high unmet public health need; early community mobilization to build awareness and support; emphasizing simplicity in the intervention technology and algorithms; using a traditional training approach appropriate to students with low literacy rates; requiring TBAs to demonstrate their competence before completing each workshop; and minimizing attrition of skills by retraining and reassessing the TBAs regularly throughout the study. Conclusion An effective NRP training model was created that is suitable for community‐based neonatal interventions, in research or programmatic settings, and by practitioners with limited obstetric skills and low rates of literacy. Clinicaltrials.gov NCT00518856 .