Mobile Virtual Simulation Training in Essential Newborn Care for Healthcare Workers in Low and Middle Income Countries

Not Applicable

Brief Summary: Intrapartum asphyxia and prematurity are the leading causes of neonatal mortality in low and middle income countries. Neonatal resuscitation training reduces asphyxia-related newborn mortality and morbidity, but in the absence of continuing low-dose, high frequency practice, these initial gains rapidly decay. The investigators propose to develop and evaluate innovative mobile virtual simulations for refresher training on neonatal resuscitation and essential newborn care to support the retention of knowledge and skills among health care workers in low and middle income countries.

Detailed Description: The main goal of this study is to improve newborn mortality and morbidity by using affordable and accessible mobile virtual simulations to provide quality skills training and maintenance for healthcare workers in Low/Middle income countries (LMIC). The investigators hypothesize that mobile devices will provide a readily accessible, standardized alternative to in-person training to maintain skills. This study has the following Specific Aims:

Specific Aim 1: Co-develop and pilot test the usability and efficacy of mobile virtual simulations on early newborn care skills among healthcare workers who attend deliveries in community and health facility-based settings.

Specific Aim 2: Evaluate the impact of the mobile virtual essential newborn care (vENC) training on neonatal resuscitation and care educational indicators and performance outcomes among healthcare workers who provide newborn care in community and health facility-based settings.

Specific Aim 3: Evaluate the impact of virtual simulation refresher training on the rates of neonatal mortality in primary, secondary and tertiary healthcare facilities in Nigeria.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Healthcare workers who have received essential newborn care course (ENCC) training within the past 12 months at time of recruitment

Arm && Interventions

Group	Intervention	Description
Intervention	Virtual Essential Newborn Care (vENC) training	Virtual Essential Newborn Care (vENC) Training

Primary Outcome Measures

Name	Time	Method
Number of participants with correct performance on essential newborn care objective structured clinical exam (OSCE) items at 6 months	at 6 months after in-person training
Early neonatal mortality	within 7 days of birth	Defined as neonatal mortality within 7 days of birth

Secondary Outcome Measures

Name	Time	Method
Intrapartum-related mortality	on day 1	Defined as intrapartum stillbirth (no breathing 10 minutes after delivery)
Number of newborns receiving recommended essential newborn care practices	within 7 days of birth	WHO essential newborn care practices include skin to skin immediately after birth, cord care, early breastfeeding and vitamin K administration
Number of participants with correct performance on essential newborn care objective structured clinical exam (OSCE) items by 12 months	at 12 months after in-person training
Number of non-breathing newborns receiving bag and mask ventilation	at delivery
Early neonatal mortality among babies requiring resuscitation	within 7 days of birth	Defined as neonatal mortality within 7 days of birth among babies requiring resuscitation

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