800 - Interprofessional neonatal resuscitation workshops - educational trials in western Mongolia

Publication Number: 800.5166

Deeba Tabibi, Texas Tech University Health Sciences Center Paul L. Foster School of Medicine, El Paso, TX, United States; Chris Wan, Keck School of Medicine of the University of Southern California, Diamond Bar, CA, United States; Hannah Nash, Keck School of Medicine of the University of Southern California, Altadena, CA, United States; Akhbikye Asylbyek, State Secondary Central Hospital, Ulaanbaatar, Ulaanbaatar, Mongolia; Janyerke Madyetkhan, Mongolian National University of Medical Sciences, Ulanbaatar, NY, United States; Balidar Nansalmaa, Medical doctor, Khovd, Hovd, Mongolia; Umit Erbolat, health Department, bayan Ulgii province, Mongolia, Ulgii, Bayan-Olgiy, Mongolia; Jargalsaikhan Badarch, Mongolian national University of medical Sciences, Ulaanbaatar, Ulaanbaatar, Mongolia; David Warburton, Children’s Hospital Los Angeles, Los Angeles, CA, United States; Elmer David, Children's Hospital Los Angeles, Los Angeles, CA, United States

Background: A quarter of neonatal deaths worldwide are attributed to birth asphyxia, with an estimated 5-10% of newborns requiring some form of respiratory support. Mongolia, a low-to-middle income country (LMIC), has an overall neonatal mortality rate of 8 per 1000 live births in 2023. Birth asphyxia is one of the main causes. A contributing factor is neonatologists mainly being found within larger cities of Mongolia, while most village populations receive neonatal care from providers who have not undergone specialized neonatal training.

Objective: We performed an experimental trial on the practicality and impact of neonatal resuscitation workshops (NRWs) for healthcare professionals in western Mongolia.

Design/Methods: Three NRWs were administered across two provinces in western Mongolia - Bayan-Olgï and Khovd - which respectively had neonatal mortality rates of 12 and 4 per 1000 live births in 2023. The NRWs were structured based on AAP’s 8th edition Neonatal Resuscitation Program (NRPⓇ) guidelines and consisted of lecture, simulation, and debrief. Participants received no compensation for participating in the workshop or filling out the assessments, which consisted of non-identifying demographic questions and skills questions. The assessments were obtained in person and participants were de-identified. Data was analyzed using R programming, including demographic percentages and ranks sum test.

Results: A total of 96 attendees completed at least one assessment, with 38 completing both. 56% of the attendees were physicians; nurses 35%; midwives 7%; and the rest were medical students (1%). 17% of the participants were neonatologists. The average years of experience was 11.8 years, with a range of 30 years. There was a significant improvement in test scores of the skills questions after the workshop was administered (p = 5.97e-07).

Conclusion(s): As far as we are aware, these neonatal resuscitation workshops are one of the first to be reported in Mongolia and studied based on NRPⓇ guidelines to examine their effectiveness. Due to the significant improvement in test scores, we can speculate that continued medical education programs can effectively increase short-term knowledge of neonatal resuscitation. Continued partnerships amongst Mongolian medical centers, Mongolian physicians, and international visiting physicians will allow more opportunities for continued medical education. Studies like this can provide a foundation for advanced NRWs throughout Mongolia and help establish a model for similar workshops in LMICs. The goal of these NRWs would be to address and reduce neonatal mortality rates, particularly in LMICs.

Objectives of the neonatal resuscitation workshop
*PPV: Positive Pressure Ventilation.
**MR SOPA: Mask adjustment, Reposition airway, Suction mouth and nose, Open mouth, Pressure increase, Alternative airway.

The design of the neonatal resuscitation workshop administered in Olgïy, Khovd city, and Darvi soum.
*PPV: Positive Pressure Ventilation.
**MR SOPA: Mask adjustment, Reposition airway, Suction mouth and nose, Open mouth, Pressure increase, Alternative airway.

Overall specialties that attended the neonatal resuscitation workshops
The overall specialties of the different healthcare professionals that attended the neonatal resuscitation workshops.

Objectives of the neonatal resuscitation workshop
*PPV: Positive Pressure Ventilation.
**MR SOPA: Mask adjustment, Reposition airway, Suction mouth and nose, Open mouth, Pressure increase, Alternative airway.

The design of the neonatal resuscitation workshop administered in Olgïy, Khovd city, and Darvi soum.
*PPV: Positive Pressure Ventilation.
**MR SOPA: Mask adjustment, Reposition airway, Suction mouth and nose, Open mouth, Pressure increase, Alternative airway.

Overall specialties that attended the neonatal resuscitation workshops
The overall specialties of the different healthcare professionals that attended the neonatal resuscitation workshops.