There are simple and cost-effective ways to reduce the main causes of newborn deaths and stillbirths. Dedicated volunteers from the Australian College of Neonatal Nurses are providing this essential training to health workers in Papua New Guinea that will save the lives of many newborn babies.

Photo: ACNN

One of the primary causes of mortality in the newborn period is the failure of neonatal care, partly due to the lack of skilled birth attendants to deliver appropriate resuscitation and care and skilled nurses to care for sick and small newborns. Birth asphyxia, that is the inability to breathe immediately after delivery, is one of three causes accounting for over 80% of newborn mortality globally. The World Health Organization estimates that one million babies die each year from birth asphyxia.

In 2013, Papua New Guinea’s newborn mortality rate was reported as 24 per 1000 births. In comparison, Australia’s newborn mortality rate is three per 1000 births and seven per 1000 births for our Indigenous population. One of the greatest contributors to PNG’s newborn mortality rate is the fact that almost half of PNG women give birth without the assistance of a doctor or midwife, relying on community workers or relatives who have never had any formal training.

The Australian College of Neonatal Nurses (ACNN) has formed a special interest group, the Low Resource Countries Special Interest Group (LRC SIG). The LRC SIG’s primary goal is to assist low resource countries such as PNG and East Timor, to reduce newborn mortality as part of the Every Newborn Action Plan and the Sustainable Development Goals. The LRC SIG commenced volunteering education and training activities in Australia’s closest neighbour, Papua New Guinea, in October 2014, after a site visit in May of the same year.

The resuscitation training concentrates on ‘The Golden Minute’ – with a few simple steps taken in the first minute after birth, newborns who struggle to breathe are given a much better start in life.  The simple steps in the Helping Babies Breathe curriculum have proven to save the lives of many newborns who struggled to breathe at birth. We have had a fantastic response, with 319 people attending our training sessions held in Goroka and its surrounding regions to date. Participants have included nurses, midwives, student nurses, student midwives, village birth attendants, community health workers, village women elders, midwifery educators and nursing educators.

What was evident during our first visit is that those working with newborns are very keen to learn and access resources that will assist them in providing the best care possible. With this in mind, and given that wireless internet was available in the neonatal nursery at the Goroka Hospital, we were keen to provide the nursery with a computer so that doctors, nurses, midwives and students could access the internet for evidence-based health care guidelines and information. The computer also now allows the hospital staff to email ACNN colleagues for advice and support.

A few of us were lucky enough to meet and train four village women elders from a remote village, Ikundi, in the Suowi Valley. The community has only been in contact with the Western world since the 1990s. It’s a two day walk to the closest government station and five days to the closest community health centre. The Ikundi women were at Goroka Hospital to participate in a two week course to provide them with some knowledge on maternal and child health, including birthing. They spoke to us through two interpreters, one that translated from their village dialect into Tok Pisin and the other from Tok Pisin to English. They told stories of babies who were believed to have died if they did not breathe at birth. They would put these babies off to the side and attend to the mother.

They were eager to learn the new techniques and left the training session with a bag full of the tools required to employ them, such as resuscitation masks, suction penguins and bunny rugs. It is incredible to see these women practice drying, suctioning and delivering mask to mouth or mouth to mouth until they achieve adequate ventilation. They are determined to learn so they can undertake these simple measures and help newborn babies breathe. Sharing experiences like these is a highlight of our work.

The Every Newborn Action Plan sets out a vision of a world in which there are no preventable deaths of newborns or stillbirths, where every pregnancy is wanted, every birth celebrated and women, babies and children survive, thrive and reach their full potential. Nearly 3 million lives could be saved each year through quality care around the time of birth and special care for sick and small newborns. ACNN is proud and humbled to be working with health professionals in other countries to work towards improving the quality of care for newborns and their families.

All photos courtesy of ACNN.

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Karen New - Vice President, Australian College of Neonatal Nurses - Lowy Institute

Karen New

Vice President, Australian College of Neonatal Nurses

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Karen New is the Vice President of the Australian College of Neonatal Nurses, a national, not-for-profit organisation that serves as the peak professional body for neonatal nurses in all states of Australia. ACNN is committed to the promotion of excellence in the care of neonates and their families throughout Australasia and worldwide by providing education and training. Find out how you can support their work in Papua New Guinea here.