Health worker training program cuts stillbirths by 30% in 6 developing countries, study says

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Feb 20 2010

The rate of stillbirths was cut by more than 30 percent after health workers in rural parts of six developing countries were trained "in how to help a newborn start breathing and to keep it warm and clean," according to a study published in the New England Journal of Medicine, Reuters reports. The trainees - who included midwives, nurses, traditional birth attendants and physicians - were given "hand-held pumps and masks to fill babies' lungs with air if they were not breathing at birth, clean-delivery kits to prevent infection and scales to measure their weight," the news service writes.

"The attendants were taught how to weigh low-weight babies, who are vulnerable, and ensure they fed properly in the first days after delivery," Reuters writes. They were also taught about proper birth hygiene and shown how to use skin-to-skin contact with the mother to keep the baby warm (Fox, 2/17).

"The randomized, controlled trial included 62,366 infants in six countries: Argentina, the Democratic Republic of Congo (DRC), Guatemala, India, Pakistan and Zambia," CBC News reports. "One health-care worker from each country travelled to the U.S. to learn the techniques and then returned home to train others until 3,600 rural health-care workers were reached," according to CBC News. At the conclusion of the trial, researchers found that stillbirths dropped from 23 per 1,000 births to 16 per 1,000.

According to the WHO, there are more than three million still births worldwide each year. CBC News continues: "Given the way the study was designed, researchers can't say for certain that it was the training that led to a reduction in stillbirths. But the researchers believe the improvements occurred among infants who had not drawn a breath on their own and would have been misidentified as stillbirths before birth attendants received the training" (2/17).

Waldemar Carlo of the University of Alabama at Birmingham, who led the study, said the work is a "breakthrough" because of the assumed difficulty of training many health workers, Reuters reports. "If implemented worldwide, such an intervention could markedly reduce perinatal mortality," Carlo said.

According to Reuters, the training program "did not affect how many live-born babies died in the first week but it slashed the rate of stillbirths." The research was funded by the U.S. National Institute of Child Health and Human Development and the Bill & Melinda Gates Foundation (2/17).

This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.