title: Skills retention in Sudanese village midwives 1 year following Helping Babies Breathe training.
abstract: BACKGROUND
  Over 80% of deliveries in Sudan occur in isolated villages, attended by village midwives (VMWs). Upgrading newborn resuscitation skills with the Helping Babies Breathe (HBB) programme could improve newborn survival rates.
  
  
  OBJECTIVE
  To describe the competencies in newborn resuscitation of selected VMWs pre-HBB and post-HBB training.
  
  
  METHODS
  In a prospective intervention study, the VMWs' performances in the HBB Objective Structured Clinical Examination B simulated scenario (manikin requiring face-mask ventilation (FMV)) were digitally recorded and analysed prior to and 3 and 12 months following HBB training. Regular manikin-based practice was encouraged following training.
  
  
  RESULTS
  Pre-HBB training, 42% of 71 VMWs (of whom 61% were functionally illiterate) stimulated the non-breathing manikin by holding it by the legs and either stimulated/slapped (30.4%) or shook (12.7%) it, while 25% (18/71) provided manikin mouth-to-mouth ventilation. The low scorings on the 'preparation for birth' (0% and 3.1% at 3 and 12 months, respectively) were mainly due to failure to demonstrate the subitem of 'cleans hands'. The percentage of VMWs providing manikin FMV within the Golden Minute increased from 37.3% (25/67) to 72.3% (47/65) (p<0.005), but there were no significant differences in the number of VMWs producing at least five FMVs at 3 months (73%, 49/67) and 12 months (58%, 38/65), respectively.
  
  
  CONCLUSIONS
  VMWs, despite a high illiteracy rate, absorbed and sustained HBB skills for at least a year. Regular, low intensity, manikin-based skills training with peers may have helped sustain FMV, but not hand-cleansing skills.
authors.affiliation: Department of Paediatrics and Child Health, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
authors.forename: Ali M E
authors.initials: AM
authors.lastname: Arabi
authors.affiliation: Department of Paediatrics and Child Health, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
authors.forename: Salah A
authors.initials: SA
authors.lastname: Ibrahim
authors.affiliation: Department of Paediatrics and Child Health, Cork University Hospital, Cork, Co Cork, Ireland.
authors.forename: Sami E
authors.initials: SE
authors.lastname: Ahmed
authors.affiliation: Department of Paediatrics and Child Health, Cork University Hospital, Cork, Co Cork, Ireland.
authors.forename: Finn
authors.initials: F
authors.lastname: MacGinnea
authors.affiliation: Department of Paediatrics and Child Health, Cork University Hospital, Cork, Co Cork, Ireland.
authors.forename: Gavin
authors.initials: G
authors.lastname: Hawkes
authors.affiliation: Department of Paediatrics and Child Health, Cork University Hospital, Cork, Co Cork, Ireland.
authors.forename: Eugene
authors.initials: E
authors.lastname: Dempsey
authors.affiliation: Department of Paediatrics and Child Health, Cork University Hospital, Cork, Co Cork, Ireland.
authors.forename: C Anthony
authors.initials: CA
authors.lastname: Ryan
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards; D003479:Curriculum; D003906:Developing Countries; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008348:Manikins; D008397:Masks; D008875:Middle Aged; D008880:Midwifery / Q000193:education*; D011446:Prospective Studies; D012151:Resuscitation / Q000193:education*; D013397:Sudan
keywords: Helping Babies Breathe; Newborn Resuscitation; Resuscitation skills; Village Midwives