Birth asphyxia, defined as the failure of the newborn to establish breathing immediately after birth, kills 814,000 newborns every year and accounts for almost a quarter of all newborn deaths.i In addition, there are an estimated 1.02 million intrapartum stillbirths every year, an unknown number of whom may be live born alive but misclassified as fresh stillbirths when no resuscitation has been provided.ii More than 98 percent of these deaths occur in low- and middle-income countries.
Approximately 10 million babies do not breathe immediately at birth, and about 6 million require basic neonatal resuscitation. According to the World Health Organization (WHO), basic newborn resuscitation requires a bag-and-mask resuscitator for ventilation, a mucus extractor (suction bulb) for suctioning, a source of warmth for thermal protection, and a clock. Sixty million home- or community-based births occur every year, but most do not have access to any resuscitation resources.iii The key to reducing deaths due to birth asphyxia is to make “appropriate care for birth asphyxia”—both neonatal resuscitation skills and appropriate devices—available to all skilled birth attendants (SBAs) and ideally to community health workers if SBAs are not available. In addition, a consistent program targeting ongoing training and local mentoring is needed to impact clinical management and patient outcome.
In order to address this issue, Helping Babies Breathe (HBB)—a USAID-funded Global Development Alliance—initiated an effort in 2010 to increase neonatal survival by offering evidence-based educational programs and high-quality, affordable neonatal resuscitation devices to SBAs in developing countries. HBB now includes 20 global alliance and implementing partners from both the private and public sectors and has attained remarkable success. The HBB training curriculum that was co-developed by the American Academy of Pediatrics, Laerdal Medical AS, and other HBB members, has been introduced in 60 countries. Global demand for newborn resuscitation has been increased by training and equipping over 130,000 health workers. Laerdal Global Health has offered developing-country programs the low-cost, high-quality neonatal resuscitation devices that were developed for low-resource settings by Laerdal Medical AS. To date, 120,000 bag-and-mask resuscitators (includes one self-inflating resuscitation bag and masks sizes 0 and 1), 150,000 Penguin Suction Devices (a multi-use suction bulb), and 50,000 NeoNatalie training manikins have been supplied to low-resource countries on a not-for-profit basis.iv