Details

Autor(en) / Beteiligte

• Xu, Tao
• Wang, Hui-shan
• Ye, Hong-mao
• Yu, Ren-jie
• Huang, Xing-hua
• Wang, Dan-hua
• Wang, Li-xin
• Feng, Qi
• Gong, Li-min
• Ma, Yi
• Keenan, William
• Niermeyer, Susan

Titel

Impact of a nationwide training program for neonatal resuscitation in China

Ist Teil von

• Chinese medical journal, 2012-04, Vol.125 (8), p.1448-1456

Ort / Verlag

China: National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing 100089, China%Department of Pediatrics, Peking University Third Hospital, Beijing 100191, China)%Department of Pediatrics, Tsinghua University First Hospital, Beijing 100016, China%Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University, Beijing 100026, China%Department of Pediatrics, Peking Union Medical College Hospital, Beijing 100730, China%Department of Pediatrics, Peking University First Hospital, Beijing 100034, China%Cardinal Glennon Children's Hospital and St. Louis University School of Medicine, St. Louis, Missouri, USA%Section of Neonatology, Children's Hospital and University of Colorado Denver School of Medicine, Colorado School of Public Health,13121 E. 17th Avenue, Mail Stop 8402, Aurora, Colorado 80045, USA

Erscheinungsjahr

2012

Quelle

MEDLINE

Beschreibungen/Notizen

• Background Seventeen million births occur in China each year. Neonatal mortality is the leading cause of under 5-year-old child deaths, and intrapartum-related injury accounts for much of mental retardation in young children. The Chinese Ministry of Health sought to improve infant and child survival through a nationwide initiative to have at least one person trained in neonatal resuscitation at every birth. The aim of the current study was to evaluate the impact of China Neonatal Resuscitation Program （NRP） on policy and infrastructure changes and its effectiveness in decreasing the incidence of mortality among newborn infants. Methods The Chinese NRP incorporated policy change, professional education, and creation of a sustainable health system infrastructure for resuscitation. Multidisciplinary teams from all 31 provinces and municipal states disseminated NRP in a train-the-trainer cascade. The intervention targeted 20 provinces with high neonatal mortality and programs to reduce maternal mortality. Program evaluation data came from 322 representative hospitals in those provinces. Results Changes in policy permitted midwives to initiate resuscitation and required resuscitation training for licensure. From 2004 through 2009 more than 110 659 professionals received NRP training in the 20 target provinces, with 94% of delivery facilities and 99% of counties reached. Intrapartum-related deaths in the delivery room decreased from 7.5 to 3.4 per 10 000 from 2003 to 2008, and the incidence of Apgar 〈7 at 1 minute decreased from 6.3% to 2.9%. Conclusions The Chinese NRP achieved policy changes promoting resuscitation, trained large numbers of professionals, and contributed to reduction in delivery room mortality. Improved adherence to the resuscitation algorithm, extension of training to the township level, and coverage of births now occurring outside health facilities can further increase the number of lives saved.