title: Implementing a simplified neonatal resuscitation protocol-helping babies breathe at birth (HBB) - at a tertiary level hospital in Nepal for an increased perinatal survival.
abstract: BACKGROUND
  Reducing neonatal death has been an emerging challenge in low and middle income countries in the past decade. The development of the low cost interventions and their effective delivery are needed to reduce deaths from birth asphyxia. This study will assess the impact of a simplified neonatal resuscitation protocol provided by Helping Babies Breathe (HBB) at a tertiary hospital in Nepal. Perinatal outcomes and performance of skilled birth attendants on management of intrapartum-related neonatal hypoxia will be the main measurements.
  
  
  METHODS
  The study will be carried out at a tertiary level maternity hospital in Nepal. A prospective cohort-study will include a six-month baseline a six month intervention period and a three-month post intervention period. A quality improvement process cycle will introduce the neonatal resuscitation protocol. A surveillance system, including CCD cameras and pulse oximeters, will be set up to evaluate the intervention.
  
  
  CONCLUSIONS
  Along with a technique to improve health workers performance on the protocol, the study will generate evidence on the research gap on the effectiveness of the simplified neonatal resuscitation protocol on intrapartum outcome and early neonatal survival. This will generate a global interest and inform policymaking in relation to delivery care in all income settings.
  
  
  BACKGROUND
  ISRCTN97846009.
authors.affiliation: International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. ashish.k.c@kbh.uu.se
authors.forename: K C
authors.initials: KC
authors.lastname: Ashish
authors.forename: Mats
authors.initials: M
authors.lastname: Målqvist
authors.forename: Johan
authors.initials: J
authors.lastname: Wrammert
authors.forename: Sheela
authors.initials: S
authors.lastname: Verma
authors.forename: Dhan Raj
authors.initials: DR
authors.lastname: Aryal
authors.forename: Robert
authors.initials: R
authors.lastname: Clark
authors.forename: P K C
authors.initials: PK
authors.lastname: Naresh
authors.forename: Ravi
authors.initials: R
authors.lastname: Vitrakoti
authors.forename: Kedar
authors.initials: K
authors.lastname: Baral
authors.forename: Uwe
authors.initials: U
authors.lastname: Ewald
mesh_terms: D001238:Asphyxia Neonatorum / Q000401:mortality / Q000628:therapy*; D002985:Clinical Protocols; D006801:Humans; D007231:Infant, Newborn; D009390:Nepal; D011446:Prospective Studies; D012151:Resuscitation / Q000379:methods*; D015996:Survival Rate; D062606:Tertiary Care Centers