Abstract
Background: Neonatal mortality rates are a challenge in low-income countries. Helping Babies Breathe (HBB) is an algorithm and a program designed to reduce the mortality rates. It was first introduced in 2010, and a revision, HBB2 was launched in 2015. HBB is an illustrational global guideline for newborn resuscitation in low-income countries, that has been taught in over 80 countries(1). As resources are limited, and the algorithm needs to include only simple measures that do not require advanced and expensive equipment. Objectives: The aim of this project thesis was to provide an overview of the literature on newborn resuscitation and newborn mortality after implementing HBB. Methods: The literature search was performed in Medline, Embase, Global health and Maternity & infant Care Database. Articles regarding the use and results of implementing HBB in low income countries were included based on predefined inclusion and exclusion criteria. Results: Fifteen studies were included in this project thesis. Ten studies showed a significant reduction in neonatal mortality, one study that did not show any significant change after implenting HBB, while one had a significant increase in neonatal mortality after implementing HBB. Six studies presented a reduction in stillbirth rates, and seven studies showed a reduction in perinatal mortality. “Low dose High Frequency” (LDHF) training was the most efficient way to maintain knowledge and skills over time. Conclusion: In this project thesis we found that the neonatal mortality has decreased after the HBB implementation according to several articles from different countries. Nevertheless, we found no additional decrease in the mortality rates after the update to the HBB2, but there is a need of studies that focuses on the effect over a longer period of time. LDHF training was effective in maintaining knowledge and skills over time.