Validation of a novel tool for assessing newborn resuscitation skills among birth attendants trained by the Helping Babies Breathe program

Jonathan Reisman; Narra Martineau; Allan Kairuki; Victor Mponzi; Amunga R Meda; Kahabi G Isangula; Erica Thomas; Marya Plotkin; Grace J Chan; Leila Davids; Georgina Msemo; Mary Azayo; Brett D Nelson

doi:10.1016/j.ijgo.2015.05.019

Validation of a novel tool for assessing newborn resuscitation skills among birth attendants trained by the Helping Babies Breathe program

Int J Gynaecol Obstet. 2015 Nov;131(2):196-200. doi: 10.1016/j.ijgo.2015.05.019. Epub 2015 Aug 5.

Authors

Affiliations

¹ Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA. Electronic address: reisman.jonathan@gmail.com.
² Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA.
³ Jhpiego, Dar es Salaam, Tanzania.
⁴ Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA; Muhimbili National Hospital, Dar es Salaam, Tanzania.
⁵ Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA; Triangle Solutions, Dar es Salaam, Tanzania.
⁶ Department of Pediatrics, Harvard Medical School, Boston, MA, USA; Division of Medical Critical Care, Boston Children's Hospital, Boston, MA, USA.
⁷ The Children's Investment Fund Foundation, London, UK.
⁸ Ministry of Health and Social Welfare, Dar es Salaam, Tanzania.
⁹ Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA.

PMID: 26283225
DOI: 10.1016/j.ijgo.2015.05.019

Abstract

Objective: To validate a simplified objective structured clinical examination (OSCE) tool for evaluating the competency of birth attendants in low-resource countries who have been trained in neonatal resuscitation by the Helping Babies Breathe (HBB) program.

Methods: A prospective cross-sectional study of the OSCE tool was conducted among trained birth attendants working at dispensaries, health centers, or hospitals in five regions of Tanzania between October 1, 2013, and May 1, 2014. A 13-item checklist was used to assess clinical competency in a simulated newborn resuscitation scenario. The OSCE tool was simultaneously administered by HBB trainers and experienced external evaluators. Paired results were compared using the Cohen κ value to measure inter-rater reliability. Participant performance was rated by health cadre, region, and facility type.

Results: Inter-rater reliability was moderate (κ = 0.41-0.60) or substantial (κ = 0.61-0.80) for eight of the OSCE items; agreement was fair (κ = 0.21-0.41) for the remaining five items. The best OSCE performances were recorded among nurses and providers from facilities with high annual birth volumes.

Conclusion: The simplified OSCE tool could facilitate efficient implementation of national-level HBB programs. Limitations in inter-rater reliability might be improved through additional training.

Keywords: Birth asphyxia; Inter-rater reliability; Intrapartum-related complications; Low-income countries; Neonatal resuscitation; Newborn care; Objective structured clinical examination.

Publication types

Research Support, Non-U.S. Gov't
Validation Study

MeSH terms

Asphyxia Neonatorum / therapy*
Clinical Competence / standards*
Cross-Sectional Studies
Humans
Infant, Newborn
Midwifery / education*
Observer Variation
Program Evaluation / methods*
Prospective Studies
Reproducibility of Results
Resuscitation / education*
Tanzania