HBB in Zambia

In Rural Zambian Clinic, Health Care Provider Attributes Success in Saving Newborns to MCHIP Support

The following piece was originally written for JHPIEGO’s blog.

Nurse Phoeby Chiluba Kaela practices newborn resuscitation with a realistic model.

As the only health care provider at the Paul Mambilima Rural Health Center, Nurse Phoeby Chiluba Kaela often works around the clock, treating suspected cases of malaria and pneumonia, providing prenatal and postnatal care for women and traveling miles to vaccinate children in their villages. That’s in addition to the births she attends several times a week.

The majority of her clients are women, and providing skilled maternal and newborn health care is her passion. A nurse-midwife for 23 years and duly trained in this area, Phoeby handles obstetric emergencies and birth complications—especially since the nearest hospital is a two- to three-hour drive over rugged terrain.

But Phoeby struggled to keep newborns alive. She lacked the proper resuscitation equipment. “Sometimes,” she explains, “I was using a syringe to suction babies and I would use a gauze to give some form of mouth-to-mouth resuscitation.”

Then in April, Brenda Mubita and Constance Choka, technical officers for the U.S. Agency for International Development’s Maternal and Child Health Integrated Program (MCHIP), delivered emergency obstetric and newborn care equipment to the Mambilima center. They also gave Phoeby an on-the-job orientation to the MCHIP-supported newborn resuscitation initiative known as “Helping Babies Breathe” (HBB).

The essential newborn care program, sponsored by MCHIP, includes newborn resuscitation, early breastfeeding and other after-birth care issues. The program uses the HBB training and an infant-size model named NeoNatalie on which health providers can practice techniques to help a newborn breathe within the first 60 seconds of life. That “ Golden Minute” is the window of time a health provider has the best chance to resuscitate a baby before it suffers injury from lack of oxygen.

MCHIP, USAID’s flagship global health award to improve mother and child survival that is led by Jhpiego, has been working for the past year to introduce and support initiatives to keep women and families alive in Zambia. Jhpiego has a 13-year history in the country, working in partnership with the government to build the capacity of health care workers in emergency obstetric and newborn care, HIV prevention and treatment, family planning and midwifery education, with support from USAID and others.

After her training in HBB and use of the NeoNatalie newborn simulator kit, Phoeby was determined to improve her practices in her clinic.

“They oriented me how to use the ‘penguin’ suction device [included in the NeoNatalie kit] and the neonatal Ambu bag,” said Phoeby. “Now I had an answer to my baby resuscitation problems.”

Anxious to master the equipment, Phoeby studied and practiced the steps of HBB, an evidence-based program that focuses on the “Golden Minute” when stimulation to breathe and ventilation with a bag and mask can save a newborn’s life. Her determination has paid off in newborn lives saved.

“The very next day I had a woman in labor who later delivered an asphyxiated baby,” said Phoeby. “I quickly picked up my penguin device and suctioned the baby. The baby didn’t cry. I remembered to dry the baby and used the neonatal Ambu bag to resuscitate the baby… I was excited as I saw the baby turning from grey to pink as I continued Ambu bagging.”

The infant soon began crying and Phoeby gave the baby to the mother for skin-to-skin care.

“A few days later, another woman came [to the clinic] and gave birth to a baby with meconium,” Phoeby said, “and again I used the penguin sucker and the Ambu bag and the baby survived. I now fully understand the importance of the Golden Minute. I will now be even more vigilant in resuscitating asphyxiated babies.”

Phoeby participated in a HBB training in Mansa last month, where she shared her experiences with other participants. She praised the resuscitation techniques and equipment, urging fellow health care workers to take their training seriously.

“I am now the talk of the village,” said Phoeby, who plans to further her nursing education this summer. “The women shared that I saved the lives of their babies with the community. I am given a lot of respect because of this hard work.”

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