{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T02:01:53Z","timestamp":1776823313212,"version":"3.51.2"},"reference-count":46,"publisher":"American Academy of Pediatrics (AAP)","issue":"Supplement_2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,1]]},"abstract":"<jats:p>The educational pedagogy surrounding Helping Babies Breathe (HBB) has been transformative in going beyond a curriculum focused only on basic neonatal resuscitation; indeed, it created the framework for an educational program that has served as a model for replication for other impactful programs, such as the Helping Mothers Survive and other Helping Babies Survive curricula. The tenets of HBB include incorporation of innovative learning strategies such as small group discussion, skills-based learning, simulation and debriefing, and peer-to-peer learning, all of which begin the hard work of changing behaviors that may eventually affect health care systems. Allowing for adaptation for local resources and culture, HBB has catalyzed innovation in the development of simplified, pictorial educational materials, in addition to low-tech yet realistic simulators and adjunct devices that have played an important role in empowering health care professionals in their care of newborns, thereby improving outcomes. In this review, we describe the development of HBB as an educational program, the importance of field testing and input from multiple stakeholders including frontline workers, the strategies behind the components of educational materials, and the impact of its pedagogy on learning.<\/jats:p>","DOI":"10.1542\/peds.2020-016915e","type":"journal-article","created":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T02:12:50Z","timestamp":1639015970000},"page":"S123-S133","source":"Crossref","is-referenced-by-count":20,"title":["Development and Impact of Helping Babies Breathe Educational Methodology"],"prefix":"10.1542","volume":"146","author":[{"given":"Nalini","family":"Singhal","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of Calgary, Calgary, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas D.","family":"McMillan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renate","family":"Savich","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dismas","family":"Matovelo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Data","family":"Santorino","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beena D.","family":"Kamath-Rayne","sequence":"additional","affiliation":[{"name":"Global Health and Life Support and American Academy of Pediatrics, Itasca, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2020,10,1]]},"reference":[{"key":"2021120822351372000_B1","unstructured":"Niermeyer\u2008S, Keenan\u2008W, Little\u2008G, Singhal\u2008N, eds. Helping Babies Breathe: facilitator flip chart. 2010. Available at: http:\/\/internationalresources.aap.org\/Resource\/ShowFile?documentName=hbb_flipchart_english.pdf. Accessed August 29, 2018"},{"key":"2021120822351372000_B2","volume-title":"Helping Babies Breathe: Facilitator Flip Chart","author":"Niermeyer","year":"2016","edition":"2nd ed"},{"issue":"3","key":"2021120822351372000_B3","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.clp.2016.04.013","article-title":"Neonatal Resuscitation in Low-Resource Settings","volume":"43","author":"Berkelhamer","year":"2016","journal-title":"Clin Perinatol"},{"key":"2021120822351372000_B4","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1542\/9781610021906-part03-ch13","volume-title":"Principles of Global Child Health: Education and Research","author":"Kamath-Rayne","year":"2018","edition":"1st ed"},{"key":"2021120822351372000_B5","unstructured":"Survive and Thrive Global Development Alliance . Guiding the way forward: survive & thrive 5-year report 2012\u20132017. 2018. Available at: https:\/\/surviveandthrive.org\/about\/Documents\/Survive%20%20Trive%205%20year%20report%20FINAL.pdf."},{"issue":"9","key":"2021120822351372000_B6","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1016\/j.resuscitation.2013.04.016","article-title":"Simulation technology for resuscitation training: a systematic review and meta-analysis","volume":"84","author":"Mundell","year":"2013","journal-title":"Resuscitation"},{"issue":"5","key":"2021120822351372000_B7","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1111\/apa.14706","article-title":"Does the Helping Babies Breathe Programme impact on neonatal resuscitation care practices? Results from systematic review and meta-analysis","volume":"108","author":"Budhathoki","year":"2019","journal-title":"Acta Paediatr"},{"issue":"3","key":"2021120822351372000_B8","doi-asserted-by":"crossref","first-page":"701","DOI":"10.11124\/JBISRIR-2017-003535","article-title":"The impact of the Helping Babies Survive program on neonatal outcomes and health provider skills: a systematic review","volume":"16","author":"Dol","year":"2018","journal-title":"JBI Database Syst Rev Implement Reports"},{"issue":"suppl 2","key":"2021120822351372000_B9","first-page":"e2020016915D","article-title":"Beyond newborn resuscitation: essential care for every baby and small babies","volume":"146","author":"Berkelhamer","year":"2020","journal-title":"Pediatrics"},{"issue":"suppl 2","key":"2021120822351372000_B10","first-page":"2020016915Me","article-title":"Using helping mothers survive to improve intrapartum care","volume":"146","author":"Evans","year":"2020","journal-title":"Pediatrics"},{"issue":"1","key":"2021120822351372000_B11","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.resuscitation.2011.07.010","article-title":"Helping Babies Breathe: global neonatal resuscitation program development and formative educational evaluation","volume":"83","author":"Singhal","year":"2012","journal-title":"Resuscitation"},{"key":"2021120822351372000_B12","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/s12887-015-0382-z","article-title":"Evaluation of an educational program for essential newborn care in resource-limited settings: Essential Care for Every Baby","volume":"15","author":"Thukral","year":"2015","journal-title":"BMC Pediatr"},{"issue":"12","key":"2021120822351372000_B13","doi-asserted-by":"crossref","first-page":"e0207909","DOI":"10.1371\/journal.pone.0207909","article-title":"Peer-assisted learning after onsite, low-dose, high-frequency training and practice on simulators to prevent and treat postpartum hemorrhage and neonatal asphyxia: a pragmatic trial in 12 districts in Uganda","volume":"13","author":"Evans","year":"2018","journal-title":"PLoS One"},{"key":"2021120822351372000_B14","first-page":"3","volume-title":"Continuing Professional Development in Medicine and Health Care: Better Education, Better Patient Outcomes","author":"Mann","year":"2017"},{"issue":"7","key":"2021120822351372000_B15","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1053\/j.semperi.2016.08.010","article-title":"Simulation and debriefing in neonatology 2016: Mission incomplete","volume":"40","author":"Halamek","year":"2016","journal-title":"Semin Perinatol"},{"issue":"5","key":"2021120822351372000_B16","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1007\/s40037-015-0214-8","article-title":"Educational outcomes of Helping Babies Breathe training at a community hospital in Honduras","volume":"4","author":"Seto","year":"2015","journal-title":"Perspect Med Educ"},{"issue":"2","key":"2021120822351372000_B17","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.ijgo.2015.05.019","article-title":"Validation of a novel tool for assessing newborn resuscitation skills among birth attendants trained by the Helping Babies Breathe program","volume":"131","author":"Reisman","year":"2015","journal-title":"Int J Gynaecol Obstet"},{"issue":"4","key":"2021120822351372000_B18","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1097\/SIH.0000000000000224","article-title":"Breaking down the objective structured clinical examination: an evaluation of the Helping Babies Breathe OSCEs","volume":"12","author":"Seto","year":"2017","journal-title":"Simul Healthc"},{"issue":"3","key":"2021120822351372000_B19","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1093\/tropej\/fms077","article-title":"\u2018Helping babies breathe\u2019 training in sub-Saharan Africa: educational impact and learner impressions","volume":"59","author":"Hoban","year":"2013","journal-title":"J Trop Pediatr"},{"issue":"1","key":"2021120822351372000_B20","doi-asserted-by":"crossref","first-page":"e34","DOI":"10.1111\/apa.12034","article-title":"Evaluating Helping Babies Breathe: training for healthcare workers at hospitals in Rwanda","volume":"102","author":"Musafili","year":"2013","journal-title":"Acta Paediatr"},{"issue":"1","key":"2021120822351372000_B21","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1186\/s12884-016-1141-3","article-title":"Helping Babies Breathe (HBB) training: What happens to knowledge and skills over time?","volume":"16","author":"Bang","year":"2016","journal-title":"BMC Pregnancy Childbirth"},{"issue":"6","key":"2021120822351372000_B22","doi-asserted-by":"crossref","first-page":"e20150117","DOI":"10.1542\/peds.2015-0117","article-title":"Reducing perinatal mortality in Nepal using Helping Babies Breathe","volume":"137","author":"KC","year":"2016","journal-title":"Pediatrics"},{"issue":"10","key":"2021120822351372000_B23","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.1111\/apa.13940","article-title":"Using quality improvement to decrease birth asphyxia rates after \u2018Helping Babies Breathe\u2019 training in Kenya","volume":"106","author":"Rule","year":"2017","journal-title":"Acta Paediatr"},{"key":"2021120822351372000_B24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.resuscitation.2015.04.019","article-title":"Frequent brief on-site simulation training and reduction in 24-h neonatal mortality\u2013an educational intervention study","volume":"93","author":"Mduma","year":"2015","journal-title":"Resuscitation"},{"issue":"2","key":"2021120822351372000_B25","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2012-1795","article-title":"Newborn mortality and fresh stillbirth rates in Tanzania after helping babies breathe training","volume":"131","author":"Msemo","year":"2013","journal-title":"Pediatrics"},{"issue":"3","key":"2021120822351372000_B26","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1093\/inthealth\/ihy017","article-title":"Resuscitation skills after Helping Babies Breathe training: a comparison of varying practice frequency and impact on retention of skills in different types of providers","volume":"10","author":"Tabangin","year":"2018","journal-title":"Int Health"},{"issue":"6","key":"2021120822351372000_B27","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1097\/SIH.0000000000000260","article-title":"The call and the challenge of pediatric resuscitation and simulation research in low-resource settings","volume":"12","author":"Rule","year":"2017","journal-title":"Simul Healthc"},{"issue":"1","key":"2021120822351372000_B28","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1186\/s12913-017-2193-4","article-title":"Implementing the Emergency Triage, Assessment and Treatment plus admission care (ETAT+) clinical practice guidelines to improve quality of hospital care in Rwandan district hospitals: healthcare workers\u2019 perspectives on relevance and challenges","volume":"17","author":"Hategeka","year":"2017","journal-title":"BMC Health Serv Res"},{"issue":"8","key":"2021120822351372000_B29","first-page":"1448","article-title":"Impact of a nationwide training program for neonatal resuscitation in China","volume":"125","author":"Xu","year":"2012","journal-title":"Chin Med J (Engl)"},{"key":"2021120822351372000_B30","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1186\/1756-0500-6-251","article-title":"Simulation-based learning combined with debriefing: trainers satisfaction with a new approach to training the trainers to teach neonatal resuscitation","volume":"6","author":"Amin","year":"2013","journal-title":"BMC Res Notes"},{"issue":"2","key":"2021120822351372000_B31","doi-asserted-by":"crossref","first-page":"196","DOI":"10.4102\/ajlm.v3i2.196","article-title":"Training-of-trainers: a strategy to build country capacity for SLMTA expansion and sustainability","volume":"3","author":"Maruta","year":"2014","journal-title":"Afr J Lab Med"},{"issue":"1","key":"2021120822351372000_B32","doi-asserted-by":"crossref","first-page":"79","DOI":"10.5588\/pha.14.0103","article-title":"Teachback methodology: building global training capacity with a unique training-of-trainers course","volume":"5","author":"Tryon","year":"2015","journal-title":"Public Health Action"},{"issue":"6","key":"2021120822351372000_B33","first-page":"669","article-title":"Helping Babies Survive Training Programs: Evaluating a Teaching Cascade in Ethiopia","volume":"29","author":"Weinberg","year":"2019","journal-title":"Ethiop J Health Sci"},{"key":"2021120822351372000_B34","unstructured":"UNICEF . Evaluation of UNICEF learning strategy to strengthen staff competencies for humanitarian response 2002\u20132004. 2005. Available at: https:\/\/www.unicef.org\/evaldatabase\/files\/Baastel_Final_Report_01132006.pdf"},{"key":"2021120822351372000_B35","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/1478-4491-7-11","article-title":"Effectiveness of a training-of-trainers model in a HIV counseling and testing program in the Caribbean Region","volume":"7","author":"Hiner","year":"2009","journal-title":"Hum Resour Health"},{"issue":"5","key":"2021120822351372000_B40","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1136\/archdischild-2015-309190","article-title":"Skills retention in Sudanese village midwives 1 year following Helping Babies Breathe training","volume":"101","author":"Arabi","year":"2016","journal-title":"Arch Dis Child"},{"key":"2021120822351372000_B36","first-page":"538","volume-title":"Glob Health Sci Pract","author":"Kamath-Rayne","year":"2018"},{"key":"2021120822351372000_B37","volume-title":"Implementing the Four Levels: A Practical Guide for Effective Evaluation of Training Programs","author":"Kirkpatrick","year":"2008"},{"issue":"1","key":"2021120822351372000_B38","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1080\/20469047.2016.1219119","article-title":"Provider experiences with the large-scale \u2018Helping Babies Breathe\u2019 training programme in Tanzania","volume":"38","author":"Isangula","year":"2018","journal-title":"Paediatr Int Child Health"},{"issue":"10","key":"2021120822351372000_B39","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1038\/jp.2017.110","article-title":"Improvements in the delivery of resuscitation and newborn care after Helping Babies Breathe training","volume":"37","author":"Kamath-Rayne","year":"2017","journal-title":"J Perinatol"},{"issue":"2","key":"2021120822351372000_B41","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2012-2112","article-title":"Stillbirth and newborn mortality in India after helping babies breathe training","volume":"131","author":"Goudar","year":"2013","journal-title":"Pediatrics"},{"issue":"2","key":"2021120822351372000_B42","first-page":"127","article-title":"Helping Babies Breathe and its effects on intrapartum-related stillbirths and neonatal mortality in low-resource settings: a systematic review","volume":"105","author":"Versantvoort","year":"2020","journal-title":"Arch Dis Child"},{"key":"2021120822351372000_B43","unstructured":"Canadian Neonatal Network . Evidence-based practice for improving quality workshop.\u20082020. Available at: https:\/\/www.ualberta.ca\/medicine\/programs\/lifelong-learning\/epiq.html. Accessed May 7, 2020"},{"issue":"1","key":"2021120822351372000_B44","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/pch\/20.1.e1","article-title":"The Evidence-based Practice for Improving Quality method has greater impact on improvement of outcomes than dissemination of practice change guidelines and quality improvement training in neonatal intensive care units","volume":"20","author":"Lee","year":"2015","journal-title":"Paediatr Child Health"},{"issue":"3","key":"2021120822351372000_B45","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1213\/ANE.0000000000002432","article-title":"Evaluation of the augmented infant resuscitator: a monitoring device for neonatal bag-valve-mask resuscitation","volume":"126","author":"Bennett","year":"2018","journal-title":"Anesth Analg"},{"issue":"6","key":"2021120822351372000_B46","doi-asserted-by":"crossref","first-page":"e0178073","DOI":"10.1371\/journal.pone.0178073","article-title":"Successful implementation of Helping Babies Survive and Helping Mothers Survive programs-An Utstein formula for newborn and maternal survival","volume":"12","author":"Ersdal","year":"2017","journal-title":"PLoS One"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/146\/Supplement_2\/S123\/912328\/peds_2020016915e.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/146\/Supplement_2\/S123\/912328\/peds_2020016915e.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T21:10:45Z","timestamp":1699909845000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/146\/Supplement_2\/S123\/68877\/Development-and-Impact-of-Helping-Babies-Breathe"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,1]]},"references-count":46,"journal-issue":{"issue":"Supplement_2","published-online":{"date-parts":[[2020,10,1]]},"published-print":{"date-parts":[[2020,10,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2020-016915e","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,1]]}}}