Remote Facilitation of Essential Newborn Care: A Multinational, Multicenter Pilot Study

BACKGROUND AND OBJECTIVES Essential Newborn Care (ENC) training improves neonatal outcomes, particularly in low-resource settings. The American Academy of Pediatrics and Laerdal Global Health developed an online platform, https://hmbs.org/, to facilitate training of health care workers (HCWs) in ENC. This study aims to examine the impact of training with the ENC course. We hypothesize that training with the ENC course, either with remote or in-person facilitation, and low-dose high-frequency (LDHF) practice improves HCW knowledge and skills. METHODS In this prospective educational intervention study, technical advisors remotely oriented in-country facilitators to ENC in Nigeria and Bangladesh. In-country facilitators then trained frontline HCWs, choosing between a remote or in-person approach based on the country context. ENC knowledge check, bag-mask ventilation (BMV) skills, and NeoNatalie Live (NNL) manikin feedback pass rates were assessed at baseline (BL), immediately posttraining (PT), and endline (EL). Objective structured clinical examination (OSCE) A and B scores were assessed at PT and EL. LDHF practice was implemented at all sites using the NNL manikin. RESULTS After remote orientation, 18 in-country facilitators trained 236 frontline HCWs at 8 sites, including 1 humanitarian setting. All sites showed significant improvement in pass rates from BL to PT in knowledge check and BMV skills. NNL pass rates generally improved from PT to EL. OSCE A and B pass rates were also generally high PT and maintained at EL. CONCLUSIONS ENC online materials coupled with LDHF practice can augment knowledge and skills in ENC and offer a flexible option for remote or in-person training.