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Kain VJ, Dhungana R, Basnet B, Basnet LB, Budhathoki SS, Fatth W, Sherpa AJ. Stakeholders' Perspectives on the "Helping Babies Breathe" Program Situation in Nepal Following the COVID-19 Pandemic. J Perinat Neonatal Nurs 2024; 38:221-220. [PMID: 38758276 DOI: 10.1097/jpn.0000000000000778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
BACKGROUND The COVID-19 pandemic impacted healthcare systems, including resuscitation training programs such as Helping Babies Breathe (HBB). Nepal, a country with limited healthcare resources, faces challenges in delivering effective HBB training, managing deliveries, and providing neonatal care, particularly in remote areas. AIMS This study assessed HBB skills and knowledge postpandemic through interviews with key stakeholders in Nepal. It aimed to identify strategies, adaptations, and innovations to address training gaps and scale-up HBB. METHODS A qualitative approach was used, employing semistructured interviews about HBB program effectiveness, pandemic challenges, stakeholder engagement, and suggestions for improvement. RESULTS The study encompassed interviews with 23 participants, including HBB trainers, birth attendants, officials, and providers. Thematic analysis employed a systematic approach by deducing themes from study aims and theory. Data underwent iterative coding and refinement to synthesize content yielding following 5 themes: (1) pandemic's impact on HBB training; (2) resource accessibility for training postpandemic; (3) reviving HBB training; (4) impacts on the neonatal workforce; and (5) elements influencing HBB training progress. CONCLUSION Postpandemic, healthcare workers in Nepal encounter challenges accessing essential resources and delivering HBB training, especially in remote areas. Adequate budgeting and strong commitment from healthcare policy levels are essential to reduce neonatal mortality in the future.
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Affiliation(s)
- Victoria J Kain
- Author Affiliations: School of Nursing and Midwifery, Griffith University, Brisbane, Australia (Dr Kain); Safa Sunaulo, Nepal (Mr Dhungana); KIST Medical College and Teaching Hospital, Nepal (Ms Basnet); Curative Service Division, Department of Health Services, Nepal (Dr Basnet); Department of Primary Care and Public Health, School of Public Health, Imperial College London, United Kingdom (Dr Budhathoki); Global Engagement Institute, Berlin, Germany (Mr Fatth); and Human Rights Peace and Development Forum, Nepal (Ms Sherpa)
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Samenjo KT, Ramanathan A, Gwer SO, Bailey RC, Otieno FO, Koksal E, Sprecher B, Price RA, Bakker C, Diehl JC. Design of a syringe extension device (Chloe SED®) for low-resource settings in sub-Saharan Africa: a circular economy approach. FRONTIERS IN MEDICAL TECHNOLOGY 2023; 5:1183179. [PMID: 37727273 PMCID: PMC10505716 DOI: 10.3389/fmedt.2023.1183179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 08/16/2023] [Indexed: 09/21/2023] Open
Abstract
Underfunded healthcare infrastructures in low-resource settings in sub-Saharan Africa have resulted in a lack of medical devices crucial to provide healthcare for all. A representative example of this scenario is medical devices to administer paracervical blocks during gynaecological procedures. Devices needed for this procedure are usually unavailable or expensive. Without these devices, providing paracervical blocks for women in need is impossible resulting in compromising the quality of care for women requiring gynaecological procedures such as loop electrosurgical excision, treatment of miscarriage, or incomplete abortion. In that perspective, interventions that can be integrated into the healthcare system in low-resource settings to provide women needing paracervical blocks remain urgent. Based on a context-specific approach while leveraging circular economy design principles, this research catalogues the development of a new medical device called Chloe SED® that can be used to support the provision of paracervical blocks. Chloe SED®, priced at US$ 1.5 per device when produced in polypropylene, US$ 10 in polyetheretherketone, and US$ 15 in aluminium, is attached to any 10-cc syringe in low-resource settings to provide paracervical blocks. The device is designed for durability, repairability, maintainability, upgradeability, and recyclability to address environmental sustainability issues in the healthcare domain. Achieving the design of Chloe SED® from a context-specific and circular economy approach revealed correlations between the material choice to manufacture the device, the device's initial cost, product durability and reuse cycle, reprocessing method and cost, and environmental impact. These correlations can be seen as interconnected conflicting or divergent trade-offs that need to be continually assessed to deliver a medical device that provides healthcare for all with limited environmental impact. The study findings are intended to be seen as efforts to make available medical devices to support women's access to reproductive health services.
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Affiliation(s)
- Karlheinz Tondo Samenjo
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
- Nyanza Reproductive Health Society, Kisumu, Kenya
| | - Aparna Ramanathan
- Nyanza Reproductive Health Society, Kisumu, Kenya
- Department of Obstetrics and Gynecology, National Center for Advanced Pelvic Surgery, Medstar Washington Hospital Center, Georgetown University, Washington, DC, United States
| | - Stephen Otieno Gwer
- Nyanza Reproductive Health Society, Kisumu, Kenya
- Department of Obstetrics and Gynaecology, Maseno University, Kisumu, Kenya
| | - Robert C. Bailey
- Nyanza Reproductive Health Society, Kisumu, Kenya
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, United States
| | | | | | - Benjamin Sprecher
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Rebecca Anne Price
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Conny Bakker
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Jan Carel Diehl
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
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Thornton M, Ishoso D, Lokangaka A, Berkelhamer S, Bauserman M, Eilevstjønn J, Iyer P, Kamath-Rayne BD, Mafuta E, Myklebust H, Patterson J, Tshefu A, Bose C, Patterson JK. Perceptions and experiences of Congolese midwives implementing a low-cost battery-operated heart rate meter during newborn resuscitation. Front Pediatr 2022; 10:943496. [PMID: 36245737 PMCID: PMC9557145 DOI: 10.3389/fped.2022.943496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/12/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND 900,000 newborns die from respiratory depression each year; nearly all of these deaths occur in low- and middle-income countries. Deaths from respiratory depression are reduced by evidence-based resuscitation. Electronic heart rate monitoring provides a sensitive indicator of the neonate's status to inform resuscitation care, but is infrequently used in low-resource settings. In a recent trial in the Democratic Republic of the Congo, midwives used a low-cost, battery-operated heart rate meter (NeoBeat) to continuously monitor heart rate during resuscitations. We explored midwives' perceptions of NeoBeat including its utility and barriers and facilitators to use. METHODS After a 20-month intervention in which midwives from three facilities used NeoBeat during resuscitations, we surveyed midwives and conducted focus group discussions (FGDs) regarding the incorporation of NeoBeat into clinical care. FGDs were conducted in Lingala, the native language, then transcribed and translated from Lingala to French to English. We analyzed data by: (1) coding of transcripts using Nvivo, (2) comparison of codes to identify patterns in the data, and (3) grouping of codes into categories by two independent reviewers, with final categories determined by consensus. RESULTS Each midwife from Facility A used NeoBeat on an estimated 373 newborns, while each midwife at facilities B and C used NeoBeat an average 24 and 47 times, respectively. From FGDs with 30 midwives, we identified five main categories of perceptions and experiences regarding the use of NeoBeat: (1) Providers' initial skepticism evolved into pride and a belief that NeoBeat was essential to resuscitation care, (2) Providers viewed NeoBeat as enabling their resuscitation and increasing their capacity, (3) NeoBeat helped providers identify flaccid newborns as liveborn, leading to hope and the perception of saving of lives, (4) Challenges of use of NeoBeat included cleaning, charging, and insufficient quantity of devices, and (5) Providers desired to continue using the device and to expand its use beyond resuscitation and their own facilities. CONCLUSION Midwives perceived that NeoBeat enabled their resuscitation practices, including assisting them in identifying non-breathing newborns as liveborn. Increasing the quantity of devices per facility and developing systems to facilitate cleaning and charging may be critical for scale-up.
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Affiliation(s)
- Madeline Thornton
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Daniel Ishoso
- School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Adrien Lokangaka
- School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Sara Berkelhamer
- Department of Pediatrics, University of Washington, Seattle, WA, United States
| | - Melissa Bauserman
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Joar Eilevstjønn
- Strategic Research Department, Laerdal Medical, Stavanger, Norway
| | - Pooja Iyer
- RTI International, Durham, NC, United States
| | | | - Eric Mafuta
- School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Helge Myklebust
- Strategic Research Department, Laerdal Medical, Stavanger, Norway
| | | | - Antoinette Tshefu
- School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Carl Bose
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jackie K Patterson
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Parsons AA, Rule ARL, Cheruiyot D, Sleeth C, Ronoh C, Mutai D, Schaffzin J, Kamath-Rayne BD. Perceptions of barriers and facilitators to disinfection of basic neonatal resuscitation equipment in a rural hospital in Kenya: A qualitative study. Midwifery 2021; 104:103200. [PMID: 34844179 DOI: 10.1016/j.midw.2021.103200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 10/22/2021] [Accepted: 10/31/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Allison A Parsons
- Division of Critical Care, Cincinnati Children's Hospital Medical Center Cincinnati, OH, United States.
| | - Amy R L Rule
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States; Divisions of Neonatology and Hospital Medicine, Cincinnati Children's Hospital Medical Center Cincinnati, OH, United States
| | | | | | | | | | - Joshua Schaffzin
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States; Division of Infectious Disease, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Beena D Kamath-Rayne
- Division of Global Health and Life Support, American Academy of Pediatrics, Itasca, IL, United States
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