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G295(P) Facilitators and barriers of continuous positive airway pressure use in newborn care in kenya (preliminary results)

Nabwera, Helen, Dickinson, Fiona ORCID:, Manu, Alexander ORCID:, Godia, Pamela, Sammy, JoyceMwende, Naimoi, BC, van den Broek, Nynke ORCID: and Mathai, Matthews ORCID: (2018) 'G295(P) Facilitators and barriers of continuous positive airway pressure use in newborn care in kenya (preliminary results)'. Archives of Disease in Childhood, Vol 103, Issue Suppl 1, A121.1-A121.

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Aim To describe the operational aspects of continuous positive airway pressure (CPAP) use in newborn care in Kenya.

Methods An ongoing nationwide survey of all health facilities in Kenya that use CPAP in newborn care. The mixed method approach used includes a standard questionnaire to describe CPAP use; key informant interviews and focus group discussions with the health care providers, to explore facilitators and barriers to CPAP use in newborn care. Descriptive statistics are used to analyse the quantitative data. A thematic framework is used to analyse the qualitative data.

Results Twenty-two health facilities in Kenya provide CPAP in newborn care, but only 18 (82%) have agreed to participate in the survey. To date the survey has been conducted in 9 (50%) of these facilities, all of which are public county referral facilities that have been using CPAP in for ≤2 years. All of them use commercial bubble CPAP acquired predominantly through donor funding and have ≤3 machines per newborn care unit. Only 7/9 (78%) of the newborn care units had a doctor or nurse who had received training on the use of CPAP, and this was often on the job clinical training. The main indications for initiating CPAP were respiratory distress and suspected pneumonia. The main barriers to CPAP use in newborn care were inadequate training of health care providers on the use of CPAP, health care provider strikes and staff shortages, and inadequate support with management of equipment when donor support ended. The main facilitators were good leadership both at the unit and facility level that supported the sustainability of CPAP use in newborn care and peer support from carers whose newborns had survived following CPAP use.

Conclusion The scale-up of CPAP use in newborn care in Kenya is well accepted by health care providers, but there are significant challenges with the sustainability of this intervention. Going forward, implementation strategies need to ensure that all staff working in newborn care units are adequately trained to safely administer CPAP, and that the health facilities are empowered to maintain the CPAP machines or have ready access to this support.

Item Type: Article
Additional Information: Abstract Only
Subjects: WS Pediatrics > WS 20 Research (General)
WS Pediatrics > By Age Groups > WS 420 Newborn infants. Neonatology
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):
Depositing User: Lynn Roberts-Maloney
Date Deposited: 26 Jan 2023 15:10
Last Modified: 26 Jan 2023 15:10


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