Successful implementation of Helping Babies Survive and Helping Mothers Survive programs-An Utstein formula for newborn and maternal survival

Globally, the burden of deaths and illness is still unacceptably high at the day of birth. Annually, approximately 300.000 women die related to childbirth, 2.7 million babies die within their first month of life, and 2.6 million babies are stillborn. Many of these fatalities could be avoided by basic, but prompt care, if birth attendants around the world had the necessary skills and competencies to manage life-threatening complications around the time of birth. Thus, the innovative Helping Babies Survive (HBS) and Helping Mothers Survive (HMS) programs emerged to meet the need for more practical, low-cost, and low-tech simulation-based training. This paper provides users of HBS and HMS programs a 10-point list of key implementation steps to create sustained impact, leading to increased survival of mothers and babies. The list evolved through an Utstein consensus process, involving a broad spectrum of international experts within the field, and can be used as a means to guide processes in low-resourced countries. Successful implementation of HBS and HMS training programs require country-led commitment, readiness, and follow-up to create local accountability and ownership. Each country has to identify its own gaps and define realistic service delivery standards and patient outcome goals depending on available financial resources for dissemination and sustainment

Illustration of the 4-stage implementation model and categories for discussion during the 1^st and 2^nd Utstein-rotation related to the “Utstein Formula for Survival” (adapted from Søreide et al [26] with permission).

<p>Illustration of the 4-stage implementation model and categories for discussion during the 1^st and 2^nd Utstein-rotation related to the “Utstein Formula for Survival” (adapted from Søreide et al [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0178073#pone.0178073.ref026" target="_blank">26</a>] with permission).</p

Tanzania: Champions of LDHF in-situ training (adapted from Perlman et al [29] with permission).

<p>Tanzania: Champions of LDHF in-situ training (adapted from Perlman et al [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0178073#pone.0178073.ref029" target="_blank">29</a>] with permission).</p

Uganda: Implementing a broader program after scanning and planning.

<p>Uganda: Implementing a broader program after scanning and planning.</p

A priori and emergent codes based on the pre-meeting inputs.

<p>A priori and emergent codes based on the pre-meeting inputs.</p

The “Utstein Formula for Survival” with different implementation scenarios (adapted from Søreide et al [26] with permission).

<p>The “Utstein Formula for Survival” with different implementation scenarios (adapted from Søreide et al [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0178073#pone.0178073.ref026" target="_blank">26</a>] with permission).</p

Essential action points for national HBS/HMS implementation.

<p>Essential action points for national HBS/HMS implementation.</p

Nepal: Formation and function of the quality improvement team.

<p>Nepal: Formation and function of the quality improvement team.</p