Table 1 Unique features of the Global Network HBB training

• Collaboration with AAP to develop training agendas for 4-day MT and 3-day BA training based on lessons learned to date

• Country level training of Facility MTs in May 2012 paired AAP MTs with experienced local MTs at the 3 Global Network sites in an intensive 4-day hands on HBB training of trainers (ToT) that was designed to

  - Train a large number of Facility MTs to minimize the training cascade and provide at least one MT per facility;

  - Rapidly rollout trainings in all facilities simultaneously;

  - Assist MTs in planning effective training of the large number of BAs in the participating facilities

• Training involved:

  - A maximum ratio of 6 trainees:1 trainer;

  - Maximal opportunities to practice in trainee groups of 6;

  - Before and after formal testing of knowledge and skills;

  - Individual sessions with the trainers.

• This MT training (ToT) included roving monitors and frequent consultation with the core group and group discussions with the new MTs to ensure that they were engaged and receiving positive feedback.

• The new MTs provided 3-day HBB training to their facility BAs between May and September 2012 with mixed groups of physician and nurse BAs. As in the 4-day MT training sessions, this 3-day facility level training of BAs had no didactic sessions; the goal was to provide maximal hands on skill training and open discussion to ensure that every BA could effectively resuscitate newborns.

• Testing before and after training was done with standard HBB tools to test resuscitation knowledge and skills, including the standard HBB Knowledge Check (written multiple choice questionnaire), BMV skills test, Objective Structured Clinical Examination (OSCE A), and a case scenario requiring BMV (OSCE B).

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