“The most exciting phrase to hear in science, the one that heralds the most discoveries, is not “Eureka!” (I found it!) but ‘That’s funny…” 

This well-known quote by author Isaac Asimov came to mind as Johnson & Johnson and partners presented important and surprising findings from two long-term programs, the China Neonatal Resuscitation Program (NRP) and Helping Babies Breathe (HBB) Training in Uganda at this week’s International Congress of Pediatrics.

The NRP and HBB clinical training programs were developed by the American Academy of Pediatrics (AAP) to address birth asphyxia – a baby’s inability to breathe in the moments after childbirth. Globally, up to 1 million children die every year, even though the condition is often survivable if health workers are available, skilled and have the equipment needed to resuscitate the baby.  Johnson & Johnson, together with the China CDC, AAP, Save the Children, USAID, and Survive & Thrive partners have invested in health worker training to reduce birth asphyxia, focusing on strengthening existing maternal and newborn health services by integrating neonatal resuscitation training, including NRP or HBB, and equipment.

From the beginning, these partnerships were designed to place a high priority on monitoring and evaluation, because partners knew that understanding the strengths and weaknesses would strengthen program implementation, and ultimately strengthen the partnership, as well.

However, those “surprising findings” sometimes can’t be discovered until years into a program, and they certainly can’t be surfaced unless a partnership is committed to investments in evaluation.

The sometimes surprising results from the evaluation of the data from both the China NRP and HBB were revealed on Thursday at a “Meet the Expert” talk hosted at the Johnson & Johnson exhibit booth.

• From the China Neonatal Resuscitation Program, we learned that inclusion of both qualitative and quantitative impact in baseline measurement helps inform a more complete program evaluation.
• We learned that overall, birth asphyxia has a very high economic cost, and while training is expensive, it’s a small cost compared to its toll on families and the economy.
• Data from the HBB partnership in Uganda revealed a much higher attrition rate of trained health workers than expected, causing unforeseen knowledge gaps.
• Additionally, mentoring or “supportive supervision” is critical to keep training current and skills strong. Without practice and guidance, quality of skills declines.

When engaging in such important, life-saving partnerships for the long-term, investing in evaluation throughout, with deeper dives into areas of concern, is essential. The discoveries made when evaluation is a priority reveal findings that shift our views to inform course corrections to increase effectiveness of current programs, transform the design of future programs, and ultimately can save lives.