We demonstrated the feasibility of using an application on a MDT to time delivery room events. This simple MDT provided valid observations of the time to crying/spontaneous respiration or BMV and was feasible to use in the low-resource setting. This is the first Android application, to our knowledge, to facilitate automatic timing of significant birth events. The BAs were able to use the devices successfully with minimal training and the recordings provided valid event timing. The majority of the BAs (83 %) felt that MDT helped them to ensure that successful ventilation was achieved within the Golden Minute. This type of device may be useful in reinforcing HBB and similar newborn resuscitation training.

This pilot study was designed to test the feasibility and acceptability of using an Android type system to collect small amounts of data. This was a pragmatic study aimed at capturing a convenience sample of deliveries thus one limitation of the study was that we were able to time less than 50 % of the deliveries with MDT due to a variety of reasons. Of the 124 BAs trained for HBB in the five facilities, only 46 BAs actually used the MDT. Therefore, only births conducted during the time the participating BAs were present in the delivery room were timed. We initially trained five facility coordinators who in turn trained other BAs working in their facilities. Hence, the training for the use of MDT occurred over a period of time and consequently not all births could be timed. Caesarean deliveries (n = 690) and those who arrived to the delivery room with signs of imminent delivery were excluded. While the Android application was useful in the field testing, the survey results suggested that further refinement and assessment using sound/voice recognition instead of the manual process to determine the time difference. Further research is needed to confirm its usefulness for a wider application. In addition, this study had limitations regarding the small number of babies requiring BMV; however, with the increasing emphasis on stimulation in HBB training, this result is not altogether surprising [4–6, 12–14]. This was a pilot study aimed at whether or not the BAs would use the MDT device. A larger study in less controlled environments may be required to assess the feasibility and larger applicability of the device. In essence, the primary focus of the MDT is to assess the feasibility of Golden Minute resuscitation by BAs trained for HBB in diverse delivery settings. Feasibility of timely resuscitation is a question that needs to be addressed, especially in resource limited settings with a single birth attendant caring for the mother and the newborn. This is not a limitation of this MDT validation study, but, rather of the HBB training program itself and the MDT may well help us answer that question in a more objective manner.