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Peer-reviewedCC BY-NC-ND 4.0BMC Pediatrics

Simulation-based neonatal resuscitation training in low- and middle-income countries: A scoping review

  • Shalu Chaudhary1
  • Medha Wadhwa2
  • Kruti Gupta3
  • Ankith Thomas4
4 affiliations
  1. 1Department of Public Health Program, Indian Institute of Public Health Gandhinagar, Gandhinagar, Gujarat India
  2. 2Department of Health Policy, Management and Behavioural Science, Indian Institute of Public Health Gandhinagar, Gandhinagar, Gujarat India
  3. 3Research Associate, Centre for Quality Improvement and Patient Safety, Indian Institute of Public Health Gandhinagar, Gandhinagar, Gujarat India
  4. 4Medical Surveillance Specialist, Iqvia, Kochi, Kerala India
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Abstract

Background: Neonatal mortality remains high in low- and middle-income countries (LMICs), where simulation-based training could enhance frontline providers’ resuscitation skills. This scoping review maps evidence on simulation-based neonatal resuscitation training for nurses, midwives, and birth attendants in LMICs.

Methods: Following PRISMA-ScR guidelines, three databases (Pubmed, Google scholar and Epistemonikos) were searched from 2015 to 2025 for studies on simulation training targeting nurses/midwives in LMICs. Two reviewers screened titles/abstracts and full texts, charting data on intervention design, outcomes, facilitators, and barriers.

Results: Seventeen studies were included, mainly from Tanzania (n = 6), India (n = 4), Uganda, Kenya, Pakistan, Zambia, Liberia, and Latin America. Interventions included Helping Babies Breathe (HBB; n = 9), PRONTO (n = 3), and low-dose refreshers, varying in duration (1–6 days), fidelity (low-high), and follow-up (immediate to 12 months). Providers showed gains in knowledge, skills (bag-mask ventilation proficiency), and confidence, but retention waned without refreshers. Barriers encompassed equipment scarcity, staffing shortages, and integration challenges.

Conclusions: Simulation training is feasible and effective short-term for LMIC providers, supporting scalable models like HBB with mentoring. Gaps in long-term neonatal outcomes and qualitative insights warrant randomized trials and policy focus on sustainability.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12887-026-07338-9.

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Cite

BibTeXRIS
BibTeX
@article{chaudhary2026simulationbased,
  title = {{Simulation-based neonatal resuscitation training in low- and middle-income countries: A scoping review}},
  author = {Shalu Chaudhary and Medha Wadhwa and Kruti Gupta and Ankith Thomas},
  journal = {BMC Pediatrics},
  year = {2026},
  month = jul,
  doi = {10.1186/s12887-026-07338-9},
  url = {https://doi.org/10.1186/s12887-026-07338-9},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Simulation-based neonatal resuscitation training in low- and middle-income countries: A scoping review
AU  - Shalu Chaudhary
AU  - Medha Wadhwa
AU  - Kruti Gupta
AU  - Ankith Thomas
PY  - 2026
DA  - 2026/07/31
JO  - BMC Pediatrics
DO  - 10.1186/s12887-026-07338-9
UR  - https://doi.org/10.1186/s12887-026-07338-9
AB  - Background: Neonatal mortality remains high in low- and middle-income countries (LMICs), where simulation-based training could enhance frontline providers’ resuscitation skills. This scoping review maps evidence on simulation-based neonatal resuscitation training for nurses, midwives, and birth attendants in LMICs.  Methods: Following PRISMA-ScR guidelines, three databases (Pubmed, Google scholar and Epistemonikos) were searched from 2015 to 2025 for studies on simulation training targeting nurses/midwives in LMICs. Two reviewers screened titles/abstracts and full texts, charting data on intervention design, outcomes, facilitators, and barriers.  Results: Seventeen studies were included, mainly from Tanzania (n = 6), India (n = 4), Uganda, Kenya, Pakistan, Zambia, Liberia, and Latin America. Interventions included Helping Babies Breathe (HBB; n = 9), PRONTO (n = 3), and low-dose refreshers, varying in duration (1–6 days), fidelity (low-high), and follow-up (immediate to 12 months). Providers showed gains in knowledge, skills (bag-mask ventilation proficiency), and confidence, but retention waned without refreshers. Barriers encompassed equipment scarcity, staffing shortages, and integration challenges.  Conclusions: Simulation training is feasible and effective short-term for LMIC providers, supporting scalable models like HBB with mentoring. Gaps in long-term neonatal outcomes and qualitative insights warrant randomized trials and policy focus on sustainability.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12887-026-07338-9.
SN  - 1471-2431
ER  -