225187 Home based life saving skills in Matlab, Bangladesh: Evaluation of a community-based maternal and newborn health program

Tuesday, November 9, 2010

Michelle M. Dynes, CNM, MSN, MPH , Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA
Lynn Sibley, PhD, CNM, FACNM, FAAN , Lillian Carter Center for International Nursing, Emory University, Atlanta, GA
Allisyn Moran, PhD , Save the Children, Washington, DC
Anisur Rahman, MPH, PhD , ICDDR,B, Dhaka, Bangladesh
Aminur Rahman, MBBS, MSc, DPS , Public Health Sciences Division, Maternal, Neonatal and Child health Programme, Matlab Health Research Center, Matlab, Chandpur, International Center For Diarrhoeal Disease And Research Bangladesh, Dhaka, Bangladesh
The purpose of the presentation is to describe an evaluation of the Home Based Life Saving Skills (HBLSS) program in rural Bangladesh. HBLSS was implemented in Matlab, Bangladesh in the ICDDR,B study area as one strategy to strengthen maternal newborn health services. Evaluation data was gathered to determine the coverage of the HBLSS program. Semi-structured interviews were conducted with families and birth attendants who reported having a baby born with birth asphyxia following a home birth (N=6). Interview transcripts were analyzed to determine which HBLSS steps were completed in response to the problem. A total of 5241 pregnant women attended HBLSS in 2008 and 2009. Ninety-three percent of women in the ICDDR,B service area attended at least one HBLSS session, while 88% attended at least two sessions. Analysis of steps taken in response to birth asphyxia revealed varying results. Three steps were conducted by nearly all respondents: 1) drying baby (83%), 2) wiping mouth and nose (100%), and 3) covering baby (83%). At least half of respondents reported 1) stimulating baby by rubbing the back (67%), blowing air into baby (67%), and calling for help (50%). Steps needing improvement include proper positioning of baby (16.7%) and referral (33.3%). Challenges with the program include: 1) loss of master trainers; 2) time commitment for participants; and 3) lack of involvement of males. Recommendations include: 1) refresher training for HBLSS guides; 2) identification of a lead HBLSS coordinator in each area; and 3) limiting the number of sessions to reduce time commitment.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice

Learning Objectives:
1. Articulate the steps taken at the community level most and least often in response to birth asphyxia following HBLSS training. 2. List the percentage of pregnant women who attended 1, 2, 3, and 4 HBLSS meetings in Matlab, Bangladesh in 2008 and 2009. 3. Discuss key challenges with the HBLSS program in Matlab, Bangladesh. 4. Describe lessons learned from the evaluation of HBLSS in Matlab, Bangladesh

Keywords: International MCH, Evaluation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I helped train and implement the HBLSS program in Matlab, Bangladesh. I also conducted the 1 year post implementation evaluation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.