‘Helping babies breathe’ in Ghana: Local group fighting infant mortality by training midwives
Published: 08-28-2023 10:40 AM |
EASTHAMPTON — In November, a local group of medical professionals and researchers will travel to Ghana to hold a training conference for Ghanaian midwives from rural health centers.
The trip is an effort of the Midwifery Exchange in Ghana, a group that formed in 2019 after recognizing a need for life-saving resuscitation training and neonatal care for babies at birth.
“We’re losing a lot of babies around the world for very low-tech reasons, with the ability to fix that problem,” said Anastasia Hallisey of Easthampton, a nurse midwife and one of the founders of the Midwifery Exchange in Ghana.
The group stemmed from a project called Helping Babies Breathe established in 2010 by the American Academy of Pediatrics.
“Helping Babies Breathe found that there were a huge portion of babies that were dying from asphyxia at birth,” Hallisey said. “Asphyxia is babies not breathing, and it is not a very difficult thing to fix, with just clearing out mucus, keeping the [umbilical] cord attached and providing oxygen, either mouth-to-mouth or through a resuscitation device.”
According to a 2022 report by the National Institutes of Health, birth asphyxia is one of the leading causes of early neonatal mortality, causing around 900,000 deaths each year.
And according to the World Health Organization, in 2019, sub-Saharan Africa had the highest neonatal mortality rate at 27 deaths per 1,000 births. Of those, 35% died of asphyxia.
Since its establishment, Helping Babies Breathe training in neonatal resuscitation techniques reduced early neonatal mortality by up to 47%, according to the American Academy of Pediatrics. The training programs have been taught to more than 850,000 providers in over 80 countries across the globe, according to the pediatric academy.
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The difficulty, according to Hallisey, is getting that training to people involved in deliveries around the world, and providing the equipment necessary to do so, especially in the global south.
That’s what the Midwifery Exchange in Ghana aims to address.
In 2019, Marie Meckel, a physician’s assistant at Baystate Medical Center whose husband is from Ghana, had been traveling to Ghana for years with students as part of a clinical rotation.
During one of her trips, Meckel became aware of how crucial midwives are to the maternal health care system in Ghana, and she recruited Hallisey to bring Helping Babies Breathe clinical training to Ghanaian midwives.
From there, Hallisey was accepted as a Fulbright specialist through the U.S. Embassy, at the request of the director of the Ministry of Health in Ghana, and organized a team to lead three small trainings on neonatal resuscitation for Ghanaian midwives, which proved to be a success.
The team, a core group abetted by an association of volunteers, consists of Massachusetts, Connecticut and Ghana-based nurses, doctors, midwives, educators, physician’s assistants and UMass Amherst researchers, all of whom donate their time for the project.
Now, with funding from the Fulbright Program and a GoFundMe, the group will return to Wa West, Ghana for two larger three-day conferences, one in November and another in February.
The conferences will train around 30 midwives each in the skills needed to become “master trainers” in the Helping Babies Breath and Essential Care for Every Baby and Small Babies curriculum, Hallisey said.
“In the United States, all health care providers need to have newborn resuscitation if they work in OB or pediatrics every two years,” explained Lindsay DuBois, a clinical nursing instructor at the UMass Amherst College of Nursing and the treasurer of the group.
“What we found through the collaboration in Ghana is that is not a requirement, so midwives may only get this education in their midwifery program, and then there’s no real renewal of those skills,” DuBois said. “As a result of that, they may be more hesitant to respond, or they may not necessarily feel… that there needs to be an intervention.”
The ultimate goal is to give Ghanaian midwives enough expertise that the U.S. team eventually becomes obsolete.
Funds go toward providing the midwives with transportation, room and board, written educational materials, and equipment such as resuscitation bags and masks, along with funding the conference itself.
The first conference, in November, will focus on the Helping Babies Breathe curriculum, similar to the previous trip.
The February trip will follow up on that curriculum with more advanced training, extending to care for small babies including looking for signs of distress, teaching parents the signs of infection, and teaching proper cord care, according to Hallisey.
At both trainings, DuBois — with the help of Cecilia Kakariba, a midwife and district director of health services in Wa West, Ghana — will conduct a research study that will evaluate the impacts of the training.
The approach to the study, as approved by the Ministry of Health and the University of Massachusetts, will be twofold.
DuBois and Kakariba will gather background from a focus group of midwives participating in the training to learn about their previous training in resuscitation, their level of anxiety around the training, and why they chose midwifery in the first place.
Three months after the training, a follow-up with the midwives will collect data on how well the resuscitation techniques are being taught and applied and whether there are any barriers preventing them from continuing the model of training.
“I think it’s just a great thing when like-minded professionals come together with these similar goals to improve outcomes for moms and newborns, and ultimately for families to be healthier,” DuBois said.
Those wishing to donate to the program can find the GoFundMe at gofund.me/1b9c51db
Maddie Fabian can be reached at mfabian@gazettenet.com.