Neonatal Resuscitation

• Verify and support the quality and integrity of the neonatal resuscitation curriculum based on the Neonatal Resuscitation Program sponsored by the American Heart Association and the American Academy of Pediatrics for use in Russia.
• Incorporate into the curriculum and complete verification of the recently translated American Heart Association/American Academy of Pediatrics Neonatal Resuscitation Program Instructors Manual.
• Determine the effectiveness of the AHA/AAP Neonatal Resuscitation Program and the impact on neonatal and obstetrical practices and outcomes within the hospitals.
• Solicit non-governmental organizational funding to support the training and certification of additional NRP providers and provide equipment and resources to associated hospitals in order that neonatal resuscitation may be properly performed.
• Promote involvement of the Ministry of Health of the Russian Federation in the development and expansion of the Neonatal Resuscitation Program.
• Provide selected didactic lectures on the basics of neonatal care and provide consultation for patient care and clinical practice policy questions and concerns.

Neurodevelopmental Pediatrics

• Establish a Neurodevelopmental Pediatrics Department at the Moscow Institute of Pediatrics and Children's Surgery.
• Establish a Neurodevelopmental Assessment Clinic at Municipal Hospital No. 13.

Information Technology

• Develop and encourage utilization of the Learning Resource Center, with acquisition of knowledge through the Internet and E-mail consultation.

• On March 15, US and Russian partners signed a Memorandum of Understanding to officially launch their partnership.
• The partnership established an AIHA-sponsored Learning Resource Center (LRC) at the Institute of Pediatrics and Children's Surgery.

• The partners opened the Neonatal Resuscitation Training Center (NRTC) in May at the Institute for Pediatrics and Children's Surgery.
• The partnership established regional methodical centers for primary neonatal resuscitation at the Tver Children's Hospital and at the Samara Regional Hospital.
• The partners established a Neurodevelopmental Pediatrics Department at the Institute of Pediatrics and Children's Surgery.
• An agreement was signed in December between the Neonatal and Perinatal Outreach Center of Virginia and North Carolina and the Institute for Pediatrics and Children's Surgery to provide close collaboration and exchange between the two organizations on issues surrounding the care and follow up of high-risk infants.
  

Neonatal Resuscitation

• The partnership implemented the American Heart Association/American Academy of Pediatrics Neonatal Resuscitation Program in Russia with training of instructors and health care providers in neonatal resuscitation. Since 1995, training and Certification in Neonatal Resuscitation of 376 Neonatologists, Pediatricians, Obstetricians, Reanimation Specialists, Anesthesiologists, Midwives, Nurses and other health care providers was completed.
• Ministry of Health Order No. 372, regarding the "elaboration of initial and critical/intensive care of the neonate in the delivery room", dated December 1995, was approved by the Russian Ministry of Health.
• Reductions in neonatal mortality have been demonstrated since implementation of the principles of the Neonatal Resuscitation Program at Maternity Hospital No. 1 (11.5 to 10.7), Maternity Hospital No. 13 (34 to 16), and Municipal Hospital No.13 Nursery (13.2 to 7.7).
• US and NIS partners worked collaboratively to replicate the success of the Moscow training center in Samara and Tver by conducting training courses for instructors and providers as well as donating training supplies and manuals.
• Reductions in infant mortality have been demonstrated in Samara from 16.4 per 1000 live births to 8.9 per 1000 life births from 1994 to 1997. During the same period reductions in the percent of infants who died within the first 24 hours of life were demonstrated as a change from 47 percent to 25 percent. Changing the way that primary neonatal resuscitation is performed in the Regional Perinatal Center of Samara has resulted in a greater utilization of oxygen therapy and more frequent use of lung mechanical ventilation with the resuscitation bag. In addition, the rate of newborns with the low five-minute Apgar score has been significantly reduced.
• Educational Improvement was demonstrated by pre-test prior to the NRP course compared to the final tests for the course. The percentage of individuals who would have failed the course prior to participating in the neonatal resuscitation training as compared to after receiving the training was 78.6 percent versus 3.6 percent respectively.
• As a result of the program, a number of the aspects of performing primary neonatal resuscitation have changed. Careful protocol follow-up while performing primary neonatal resuscitation, tracheal intubation, and teamwork have been implemented. The frequency of oxygen therapy (mask ventilation) through a respiratory bag or through an intubation tube, if needed, has increased. The frequency of pharmaceutical use has been significantly decreased. Lastly, an initial and intensive/critical care chart is filled out for each child. Careful protocol follow-up while performing primary neonatal resuscitation, tracheal intubation, and teamwork with an assistant.

Information Technology

• An Educational Program Center was established at a newly renovated site at the Institute of Pediatrics and Children's Surgery. New positions of manager and computer operator have been introduced at the Center.
• A computerized text with interactive questions and answers is being created using the principles based on the Neonatal Resuscitation Program sponsored by the American Heart Association and the American Academy of Pediatrics for use in Russia. The Learning Resource Center has been instrumental in providing the necessary technology and support for this project.
• A Web page has been developed to help improve communication with other health care centers and foster mutually beneficial relationships.

Neurodevelopmental Pediatrics

• The partners established a Neurodevelopmental Assessment Clinic at Municipal Hospital No. 13. As of September 1998, approximately 300 high-risk premature infants had been followed serially by the clinic.
• Training videos have been made for neurodevelopmental evaluation utilizing the Russian translated Clinical Adaptive Test/Clinical Linguistic Auditory Milestone Scale (CAT/CLAMS) for premature infants.
• The partnership published a manuscript titled: "Neurodevelopmental Pediatrics in Russia: The Follow-Up of High-Risk Premature Infants in Moscow, Russia" in International Child Health.