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Evaluation of a Neonatal Resuscitation Curriculum in Liberia

Department of Emergency Medicine, University of Texas at Southwestern Medical Center, Dallas, TX 75390, USA
Department of Anesthesiology/Pediatric Anesthesiology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
Department of Pediatrics, Division of Emergency Medicine, The Children’s Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA 19104, USA
Office of Emergency Training, Response, and Evaluation, Johns Hopkins School of Medicine, Baltimore, MD 21205; USA
Ministry of Health and Social Welfare, P. O. Box 10-9009 1000, Monrovia 10, Liberia
Department of Anesthesiology/Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
Author to whom correspondence should be addressed.
Children 2019, 6(4), 56;
Received: 18 March 2019 / Revised: 3 April 2019 / Accepted: 4 April 2019 / Published: 8 April 2019
(This article belongs to the Special Issue Emerging Concepts in Neonatal Resuscitation)
PDF [218 KB, uploaded 21 April 2019]


Neonatal mortality in Africa is among the highest in the world. In Liberia, providers face significant challenges due to lack of resources, and providers in referral centers need to be prepared to appropriately provide neonatal resuscitation. A team of American Heart Association health care providers taught a two-day neonatal resuscitation curriculum designed for low-resource settings at a regional hospital in Liberia. The goal of this study was to evaluate if the curriculum improved knowledge and comfort in participation. The curriculum included simulations and was based on the Neonatal Resuscitation Protocol (NRP). Students learned newborn airway management, quality chest compression skills, and resuscitation interventions through lectures and manikin-based simulation sessions. Seventy-five participants were trained. There was a 63% increase in knowledge scores post training (p < 0.00001). Prior cardiopulmonary resuscitation (CPR) training, age, occupation, and pre-intervention test score did not have a significant effect on post-intervention knowledge test scores. The median provider comfort score improved from a 4 to 5 (p < 0.00001). Factors such as age, sex, prior NRP education, occupation, and post-intervention test scores did not have a significant effect on the post-intervention comfort level score. A modified NRP and manikin simulation-based curriculum may be an effective way of teaching health care providers in resource-limited settings. Training of providers in limited-resource settings could potentially help decrease neonatal mortality in Liberia. Modification of protocols is sometimes necessary and an important part of providing context-specific training. The results of this study have no direct relation to decreasing neonatal mortality until proven. A general resuscitation curriculum with modified NRP training may be effective, and further work should focus on the effect of such interventions on neonatal mortality rates in the region. View Full-Text
Keywords: neonatal resuscitation; newborn resuscitation; neonatal mortality; simulation training; cardiopulmonary resuscitation neonatal resuscitation; newborn resuscitation; neonatal mortality; simulation training; cardiopulmonary resuscitation
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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MDPI and ACS Style

Chang, M.P.; Walters, C.B.; Tsai, C.; Aksamit, D.; Kateh, F.; Sampson, J. Evaluation of a Neonatal Resuscitation Curriculum in Liberia. Children 2019, 6, 56.

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