Background: About 10% of all newborns may have difficulty breathing and require support by trained personnel. In Peru, 90% of deliveries occur in health facilities. However, there is not a national neonatal resuscitation and certification program for the public health sector. In addition, the Andes and the Amazon regions concentrate large rural remote areas, which further limit the implementation of training programs and the accomplishment of continuous certification. Neonatal resuscitation training through the use of Information, Communication and Technology (ICT) tools, running on computers, tablets or mobile phones, may overcome such limitations. This strategy allows online and offline access to educational resources, paving the way to more frequent and efficient training, and certification processes.

Objective: To evaluate the effects of a neonatal resuscitation training and certification program that uses a Multi-Platform ICT (MP-ICT) strategy on neonatal health care in remote areas.

Methods: We propose to conduct the study through a cluster-randomized trial, where the study and analysis unit is the health care facility. Eligible facilities will include primary and secondary health care level facilities that are located in provinces with neonatal mortality rates higher than 15 per 1,000 live births. We will compare the proportion of newborns with a heart rate ≥100 beats per minute at two minutes after birth in health care facilities that receive MP-ICT training and certification implementation, with those that receive standard training and certification.

Discussion: We expect that the intervention will be shown as more effective than the current standard of care. We are prepared to include it within a national neonatal resuscitation training and certification program to be implemented at national scale together with policymakers and other key stakeholders.

Trial registration: ClinicalTrials.gov Nº NCT03210194

Status of the study: This study is enrolling participants by invitation only.

Study protocol version 1.1 – March 31st, 2017

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Publication Date


Notes/Citation Information

Published in F1000Research , 6, 1599, p. 1-14. [version 3; referees: 2 approved].

Copyright: © 2018 Delgado CA et al.

This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Data associated with the article are available under the terms of the Creative Commons Zero "No rights reserved" data waiver (CC0 1.0 Public domain dedication).

The RCPNEOPERU study group is composed of Peruvian paediatricians, neonatologists and nurses devoted to the care of newborns. Many of them work at the Instituto Nacional de Salud del Niño (INSN) in Lima, Peru, and perform clinical care activities, clinical teaching and scientific research.

Amendments from Version 2

We have made changes in response to the Dr. Sajid Soofi and Shabina Ariff. We have revised the “Description of the Interventions” section and we added a paragraph at the end of this section to further emphasize that we will assess and compare the theoretical knowledge and clinical skill of health workers.

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Funding Information

Stars in Global Health, Round 8: Reproductive, Maternal, Newborn and Child Health. Grand Challenges Canada (grant number R-ST-POC-1707-06330).

113374ab-5b2d-4224-923c-c33c4ced6528.docx (99 kB)
Supplementary File 1: Trial registration data

e0724d87-cd11-4568-938c-149c684bd08f.htm (48 kB)
Supplementary File 2: An example of MP-ICT

8d17e0dc-bacb-450b-ab4a-792c7b0c3fbb.zip (52 kB)
Supplementary File 3: Observation sheet

e6333ffe-88b7-4cba-bf54-4d9a34ce7dba.zip (813 kB)
Supplementary File 4: Consent form for health professionals (version 2.0)

7627c019-fc1a-410f-9e7e-8b28b0186ae9.zip (799 kB)
Supplementary File 5: Consent form for mothers (version 2.0)

3c7b9144-da40-4202-bcd0-06af32746b0f.docx (58 kB)
Supplementary File 6: Completed SPIRIT checklist

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