Sixty seconds – that is all it takes to breathe life into a newborn that is gasping for air. This is the golden minute that can mean the difference between life and death for a newborn who is not breathing. Jubaida, the community midwife, from Bangladesh was trained and equipped to act rapidly and appropriately when she heard no cry and felt no breathing when Baby Shifa was born. Jubaida gently dried and rubbed the baby and, as the family looked on, she used a bag and mask and helped Baby Shifa breathe as the hands of the clock ticked by.
Every year, 10 million babies require help to breathe immediately after birth. Simple means to stimulate breathing, including drying and rubbing, and ventilation with bag and mask, could save the majority of these babies. Such lifesaving care is currently only available for less than one out of four newborns. Scaling up newborn resuscitation is challenging because it requires provider skills, appropriate equipment, and systems strengthening. In order to meet the Millennium Development Goal 4, birth attendants in large numbers must acquire the basic skills and equipment to help newborns breathe.
Challenged by this, USAID searched for a feasible and effective approach to scale up newborn resuscitation and found the answer in the Global Development Alliance model. On June 16, 2010, USAID launched a Global Development Alliance (GDA). The objective of the GDA is to reduce newborn mortality by expanding access to high-quality, affordable newborn resuscitation training materials and devices, improving the competence of birth attendants to resuscitate newborns, strengthening health systems and promoting global commitment and resources for life-saving newborn care. A seemingly impossible task of scaling up newborn resuscitation became programmatically possible by bringing together diverse partners in an alliance.
This partnership is ground-breaking in many ways. The GDA model is a new way of doing business in the field of newborn health and has now become a key USAID strategy to roll out newborn resuscitation globally. The approach is not without risks since, except for the long-standing partnership between USAID and Save the Children, it has forged a partnership between other organizations who had not previously worked together. The GDA has also brought two USG Agencies – NICHD and USAID – together in a concrete and actionable way that took advantage of each Agency’s comparative advantage, i.e., NICHD’s research capacity and USAID’s program implementation capacity. The individual partners of the GDA are themselves creators of innovative solutions: Laerdal developed a very low cost, life-like manikin (NeoNatalie) and a transparent suction bulb in response to the global need for a low-cost, resuscitation training simulator and an easy-to-clean and boilable device to clear the newborn’s airway; these life-saving technologies are available on a not-for profit basis to all 68 Millennium Development Goal countries. AAP developed the “Helping Babies Breathe” curriculum that simplified the resuscitation action algorithm so that it can be implemented even in peripheral health facilities and communities.
Within six months of launching the GDA, 17 countries are planning to integrate “Helping Babies Breathe” within their newborn programs, AAP has pledged to train one million health providers by 2015, and Laerdal decided to spin off a new company called Laerdal Global Health to focus on developing new technologies at the base of the pyramid to address maternal and child health.