Neonatal resuscitation skills retention among healthcare providers one year after implementation of in situ low-dose high-frequency simulations using innovative tools across two regions in Tanzania

Background The Safer Births Bundle of Care (SBBC) was introduced in five regions in Tanzania to improve the quality of care around birth. Among the interventions was an initiative to train healthcare providers on neonatal resuscitation following the Helping Babies Breathe curriculum, using innovative simulation tools.Objectives This study aimed to assess simulated neonatal resuscitation skills retention and associated factors one year after implementation.Methods A longitudinal study among healthcare providers working in the labour wards of 12 facilities in two regions undergoing SBBC implementation. Healthcare providers were trained and evaluated at baseline and one year after implementation of in situ self-regulated individual skill training. A paired t-test was used to compare the mean difference in skills scores, while factors associated with skills retention were assessed using a modified Poisson regression analysis.Results Among 226 participants, 174 (77%) retained skills one year after the implementation. The mean skills score at baseline was 92.5% compared to 82.3% after one year, with a mean difference of 10.2 (95% CI: 8.7–11.7); p < 0.001. Sex was independently associated with skills retention; males were less likely to retain skills than females, with an adjusted prevalence ratio (APR) = 0.90 (95%CI: 0.86–0.97); p = 0.02.Conclusion The majority of healthcare providers retained simulated neonatal resuscitation skills. There was an overall mean skills drop compared to baseline, highlighting the need to strengthen the approaches supporting long-term skills retention. Barriers to and facilitators of sustained effects and scalability should be explored.