This report examines the implementation and evaluation of NeoNatalie Live (NNL) smart newborn resuscitation training simulators across five healthcare facilities in Bangladesh through Save the Children’s SWAP project from 2024-2025. The NNL is an innovative data-driven training tool that provides real-time feedback on newborn resuscitation techniques, addressing the critical challenge that birth asphyxia poses to neonatal mortality in Bangladesh. The simulator connects to mobile devices via Bluetooth and uses realistic patient scenarios based on 1,200 real ventilation cases to help healthcare providers practice life-saving skills.
The intervention was rolled out using a cascade training approach and low-dose, high-frequency practice model across Bangabandhu Sheikh Mujib Medical University, MR Khan Shishu Hospital, Mohammadpur Fertility Services & Training Centre, Sylhet MAG Osmani Medical College Hospital, and Lakshmipur Sadar Hospital. Over 2,197 resuscitation training sessions were conducted between July 2024 and January 2025, with each facility receiving one simulator and designating a focal person to encourage regular practice among healthcare providers in Special Care for Newborn Units.
Evaluation results demonstrated measurable improvements in resuscitation performance across multiple clinical parameters. Success rates varied by facility, ranging from 20% to 79%, with four out of five facilities showing improvement over time. Healthcare providers showed better adherence to recommended ventilation rates (targeting 40 breaths per minute), reduced instances of insufficient air pressure during ventilation, and nearly universal correct head positioning during resuscitation attempts. Two facilities achieved close to the recommended 60-second timeframe for achieving spontaneous breathing by the final evaluation phase.
Qualitative feedback revealed that healthcare providers found the NNL training more engaging than traditional methods, with many citing increased confidence and the compelling nature of the manikin “crying” when resuscitation was successful. However, implementation challenges included high patient loads limiting practice time, frequent staff rotations interrupting continuity, internet connectivity issues, and shared login credentials that complicated individual performance tracking. The report concludes that NNL represents a promising approach for maintaining newborn resuscitation skills and recommends broader adoption across Bangladesh’s healthcare facilities, with emphasis on ensuring reliable internet access and reducing staff rotation in newborn care units.
