Resuscitation 80 (2009) 1308–1311 Contents lists available at ScienceDirect Resuscitation journal homepage: www.elsevier.com/locate/resuscitation Simulation and education Evaluating the effectiveness of a strategy for teaching neonatal resuscitation in West Africa  Christabel Enweronu-Laryea a,* , Cyril Engmann b , Alexandra Osafo c , Carl Bose d a Department of Child Health, University of Ghana Medical School, P. O. Box 4236, Accra, Ghana b Division of Neonatal-Perinatal Medicine, School of Medicine & School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7596, USA c Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana d Division of Neonatal-Perinatal Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7596, USA article info Article history: Received 22 April 2009 Received in revised form 29 June 2009 Accepted 2 August 2009 Keywords: Neonatal resuscitation Ghana Training abstract Aim: To evaluate the effectiveness of a strategy for teaching neonatal resuscitation on the cognitive knowledge of health professionals who attend deliveries in Ghana, West Africa. Methods: Train-the-trainer model was used to train health professionals at 2–3 day workshops from 2003 to 2007. Obstetric Anticipatory Care and Basic Neonatal Care modules were taught as part of Neonatal Resuscitation Training package. American Neonatal Resuscitation Program was adapted to the clinical role of participants and local resources. Cognitive knowledge was evaluated by written pre- and post-training tests. Results: The median pre-training and post-training scores were 38% and 71% for midwives, 43% and 81% for nurses, 52% and 90% for nurse anaesthetists, and 62% and 98% for physicians. All groups of the 271 professionals (18 nurse anaesthetists, 55 nurses, 68 physicians, and 130 midwives) who completed the course showed significant improvement (p < 0.001) in median post-training test scores. Midwives at primary health care facilities were less likely to achieve passing post-test scores than midwives at secondary and tertiary facilities [35/53 vs. 24/26 vs. 45/51 (p = 0.004)] respectively. Conclusion: Evidence-based neonatal resuscitation training adapted to local resources significantly improved cognitive knowledge of all groups of health professionals. Further modification of training for midwives working at primary level health facilities and incorporation of neonatal resuscitation in continuing education and professional training programs are recommended. © 2009 Elsevier Ireland Ltd. All rights reserved. 1. Introduction Perinatal asphyxia, a potentially modifiable cause of neona- tal mortality and morbidity affects over four million newborns in developing countries annually. About 1.2 million of affected infants die and at least the same number develop severe consequences such as cerebral palsy. 1,2 Perinatal asphyxia is a major cause of neonatal mortality in Ghana. 3–6 Improving neonatal resuscitation skills of health profession- als reduces neonatal mortality and morbidity. 7,8 However, health professionals in sub-Saharan Africa feel professionally inad- equate to provide neonatal resuscitation because they lack adequate knowledge, skills, and basic equipment for emergency  A Spanish translated version of the abstract of this article appears as Appendix in the final online version at doi:10.1016/j.resuscitation.2009.08.005. * Corresponding author. Tel.: +233 20 815 4886. E-mail addresses: chikalaryea@yahoo.com (C. Enweronu-Laryea), cengmann@med.unc.edu (C. Engmann), ayisibea2000@yahoo.com (A. Osafo), cbose@med.unc.edu (C. Bose). perinatal care. 9,10 These barriers could be reduced with train- ing. The American Academy of Paediatrics (AAP) and American Heart Association (AHA) Neonatal Resuscitation Program (NRP) is an effective training tool for improving knowledge and skills of health professionals, 11,12 and the standard of care for preventing adverse outcome in asphyxiated newborns. 13 Neonatal resuscitation train- ing programs are non-existent in many west African countries. To improve the knowledge and skills of health professionals who care for the newborn, we started multi-component workshops in Ghana in 2003. We report the strategy used to implement training and the effect of training on cognitive knowledge. 2. Methods The workshops were organized by Department of Child Health, Korle Bu Teaching Hospital (KBTH), Accra from October 2003 to September 2007. Each workshop lasted 2–3 days and comprised of 3 modules: (a) Obstetric Anticipatory Care for identifying the foetus at risk, (b) Basic Neonatal Care based on the World Health Orga- 0300-9572/$ – see front matter © 2009 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.resuscitation.2009.08.005