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

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.