Barriers and facilitators to implementing bubble CPAP to improve neonatal health in sub-Saharan Africa: a systematic review.

Barriers and facilitators to implementing bubble CPAP to improve neonatal health in sub-Saharan Africa: a systematic review.

The World Health Organization strongly recommend using bubble CPAP for premature infants with respiratory distress. Therefore, it is important to understand the barriers and facilitators for its implementation. This review evaluates the barriers and facilitators of bubble CPAP implementation in newborn care at sub-Saharan African health facilities and how different facility levels and types of bubble CPAP systems may impact utilization.

In this meta-analysis, Kinshella et al searched databases from inception to July 2019 in MEDLINE Ovid, EMBASE, CINAHL, The Cochrane Central Register of Controlled Trials (CENTRAL), the WHO Regional Database for Africa, African Index Medicus (AIM), African Journals Online and Grey literature. Authors’ inclusion criteria were studies that discussed bubble CPAP implementation with neonates less than ≤ 28 days old at a health facility in sub-Saharan Africa.

Authors found that reliable availability of equipment, effectively informing and engaging caregivers and staffing shortages were among the most common mentioned barriers in addition to understaffed neonatal units and high turnover of nurses and doctors. Provider-to-provider clinical mentorship and cost-effectiveness of innovative bubble CPAP systems were identified as facilitators of implementation. Read more

Kinshella et al: Barriers and facilitators to implementing bubble CPAP to improve neonatal health in sub-Saharan Africa: a systematic review. Public Health Rev. 2020 Apr 28;41:6. PMID: 32368359