More than 150,000 newborn lives have been saved and birth-asphyxia-related infant mortality has been reduced by 75% in China since the launch of Freedom of Breath, Fountain of Life — China’s Neonatal Resuscitation Program (China NRP) in 2004.
China NRP aims to reduce the infant mortality and disability rates caused by asphyxia.China Neonatal Resuscitation Program (NRP) partners gathered in Beijing to celebrate newborn lives saved over the past 10 years. From left: Susan Niermeyer, M.D., M.P.H., FAAP, HBB master trainer; Feng Qi, M.D., FAAP, China NRP Committee member; William J. Keenan, M.D., FAAP, HBB master trainer; and Henry C. Lee, M.D., FAAP, NRP Steering Committee member.
Now, 90% of the country’s labor and delivery facilities have at least one trained attendant. Most recent estimates from hospitals across key provinces also point to a decrease in mortality from asphyxia in the delivery room from 7.55 per 10,000 live births in 2003 to 3.21 per 10,000 live births in 2008.
The Academy, Chinese Ministry of Health and Johnson & Johnson have big plans as they enter the program’s third phase. China will expand the Helping Babies Breathe (HBB) program in tandem with China NRP, an approach that is fairly unique to the country, said Henry C. Lee, M.D., FAAP, a member of the NRP Steering Committee. Usually, just one or the other is used, depending on the country’s needs.
“China is such a big and disparate country that both programs are applicable depending on the setting,” he said. HBB’s evidence-based educational program teaches neonatal resuscitation techniques to birth attendants in resource-limited areas and developing countries.
For the past five years, Dr. Lee has traveled annually to China for task force meetings and to provide curriculum updates. The group has navigated language barriers to identify and train as many people as possible in a health system with geographic and systemic obstacles.
About 10% of the world’s neonatal deaths occur in China each year, the second-highest number among all nations. Reducing it has become a main priority for the centrally governed health care system, according to a NeoReviews article co-authored by Dr. Lee (http://bit.ly/2b2NdIq).
Plans are in place to help measure the impact of NRP and HBB. Data system improvements will help track the number of trainees, find hospitals and areas lacking adequate training, and record clinical data on babies’ outcomes. China does not have a centralized birth database, but it is working on a sampling strategy to improve assessments, said Dr. Lee.
About 250,000 clinicians have been trained in more than 30 Chinese provinces. But provinces with fewer resources still need more people trained.
The Academy is committed to expanding the core group of trainers to include energetic and motivated young trainers who will help carry the program forward and preserve the quality of training, Dr. Lee said. “This type of work takes the effort of so many people.”