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Dr Matthew Ellis

Impact

Clinical Community Paediatrician for North Bristol NHS Trust providing services to the children and young people of North Bristol

International Child Health Group, specialty advisory group of the Royal College of Paediatrics and Child Health

Research findings

Infants born in rural Bangladesh who remain in poor condition at five minutes of age are at 20% risk of death by one month of age (the 'neonatal' period) and account for 35% of all neonatal deaths in this setting.

Traditional Birth Attendants (TBA's) can aquire resuscitation competencies using bag-valve-mask devices.

A community based programme to teach traditional birth attendants to use bag-valve-mask resuscitation for such infants was ineffective in terms of reducing neonatal mortality compared to mouth-to-mouth resuscitation training for traditional birth attendants in neighbouring control areas.

There were relatively few device based resuscitations performed in the intervention area and the control area TBAs had their mouth-to mouth resuscitation competency enhanced during the programme, Thus the net effect of this programme intervention was to dilute potential benefits of selective training of TBAs in device based resuscitation. But it reminds programmers of the challenges of achieving high level coverage with a device based intervention at the community level for an unplanned event.