{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:22:35Z","timestamp":1790727755054,"version":"4.1.0"},"reference-count":23,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,2,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Early neonatal mortality has remained high and unchanged for many years in Tanzania, a resource-limited country. Helping Babies Breathe (HBB), a novel educational program using basic interventions to enhance delivery room stabilization\/resuscitation, has been developed to reduce the number of these deaths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Master trainers from the 3 major referral hospitals, 4 associated regional hospitals, and 1 district hospital were trained in the HBB program to serve as trainers for national dissemination. A before (n = 8124) and after (n = 78\u2009500) design was used for implementation. The primary outcomes were a reduction in early neonatal deaths within 24 hours and rates of fresh stillbirths (FSB).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Implementation was associated with a significant reduction in neonatal deaths (relative risk [RR] with training 0.53; 95% confidence interval [CI] 0.43\u20130.65; P \u2264 .0001) and rates of FSB (RR with training 0.76; 95% CI 0.64\u20130.90; P = .001). The use of stimulation increased from 47% to 88% (RR 1.87; 95% CI 1.82\u20131.90; P \u2264 .0001) and suctioning from 15% to 22% (RR 1.40; 95% CI 1.33\u20131.46; P \u2264 .0001) whereas face mask ventilation decreased from 8.2% to 5.2% (RR 0.65; 95% CI 0.60\u20130.72; P \u2264 .0001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>HBB implementation was associated with a significant reduction in both early neonatal deaths within 24 hours and rates of FSB. HBB uses a basic intervention approach readily applicable at all deliveries. These findings should serve as a call to action for other resource-limited countries striving to meet Millennium Development Goal 4.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2012-1795","type":"journal-article","created":{"date-parts":[[2013,1,21]],"date-time":"2013-01-21T20:48:41Z","timestamp":1358801321000},"page":"e353-e360","source":"Crossref","is-referenced-by-count":336,"title":["Newborn Mortality and Fresh Stillbirth Rates in Tanzania After Helping Babies Breathe Training"],"prefix":"10.1542","volume":"131","author":[{"given":"Georgina","family":"Msemo","sequence":"first","affiliation":[{"name":"Ministry of Health and Social Welfare, Dar es Salaam, Tanzania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augustine","family":"Massawe","sequence":"additional","affiliation":[{"name":"Paediatrics and Child Health, School of Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donan","family":"Mmbando","sequence":"additional","affiliation":[{"name":"Ministry of Health and Social Welfare, Dar es Salaam, Tanzania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neema","family":"Rusibamayila","sequence":"additional","affiliation":[{"name":"Ministry of Health and Social Welfare, Dar es Salaam, Tanzania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Manji","sequence":"additional","affiliation":[{"name":"Paediatrics and Child Health, School of Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussein Lesio","family":"Kidanto","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damas","family":"Mwizamuholya","sequence":"additional","affiliation":[{"name":"Paediatrics, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prisca","family":"Ringia","sequence":"additional","affiliation":[{"name":"Division of Obstetric Nursing, Weill Bugando Hospital, Mwanza, Tanzania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hege Langli","family":"Ersdal","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Stavanger University Hospital, Norway and Haydom Lutheran Hospital, Tanzania;"},{"name":"SAFER (Stavanger Acute medicine Foundation for Education and Research), Stavanger University Hospital, Stavanger, Norway; 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