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As part of our “Population, Health, and Environment” (PHE) Program, SAVA Conservation supports a variety of
human health projects, such as family planning, in villages near Marojejy National Park. Recently, we sought to ex-
pand our health program to newborn infant care, since neonatal mortality is rather high in Madagascar: 21 new-
born infants die within the first
month after birth per 1000 births.
This is higher than the global neona-
tal mortality rate (20), and much
higher than the USA (4), but still
considerably less than west and
central Africa (35) (WHO, 2013).
Approximately 26% of neonatal
deaths in developing countries are
due to asphyxia or difficulty breath-
ing which can actually be prevent-
ed, saving babies, if health care
workers have sufficient training and
resuscitation equipment. In some
cases, infants may appear to be
dead and not breathing but can still
be resuscitated.
In May of this year, we were de-
lighted to host Dr. Alison Leaf and
her husband Dr. Andrew Wilkinson.
They are both Professors and Neo-
natologists (Pediatricians that spe-
cialize in newborn infants) from England who organized and taught several “Helping Babies Breathe” (HBB) training
courses to doctors and nurses in Sambava and Andapa. It is only because of their tremendous drive and passion for
Madagascar and neonatal health that these trainings were a huge success. We thank them greatly! Below we ask
Dr. Leaf and Dr. Wilkinson some questions about the HBB Trainings:
1) What is the "Helping Babies Breathe" Training Program?
Helping Babies Breathe is a neonatal resuscitation course for use in resource-limited settings. It was developed
by the American Academy of Pediatrics, Laerdal-Global health, United Nations, USAID and other organisations on
the premise that assessment at birth and simple newborn care are things that every baby deserves. The steps
taught in HBB can save lives and give a much better start to many babies who struggle to breathe at birth and aims
to meet the needs of every baby born. Helping Babies Breathe emphasizes skilled attendants at birth, assessment
of every baby, temperature support, stimulation to breathe, and assisted ventilation as needed, all within "The
Golden Minute" - the first minute after birth. It addresses one of the three main causes of neonatal mortality and
has been widely taught and implemented in many countries. This website can provide more information:
2) Why was it important to conduct trainings in the SAVA region?
Madagascar has made a great commitment to reducing maternal and child mortality in line with the Millennium
Development Goals (4 and 5), and the more recent WHO ‘Every Newborn Action Plan’. However it is a large country
Supporting Medical Training Programs to Help Newborn Infants
by Dr. Erik Patel
Training in action at the SAVA Conservation office.
