Sangwani Salimu
Severe respiratory distress is a leading cause of mortality among neonates in Malawi. In spite of evidence on the safety, cost effectiveness and efficacy of bubble continuous positive airway pressure (CPAP) in managing the condition, little is known about the perspectives of mothers and guardians with babies on bubble CPAP. The purpose of this study was to explore caregiver perspectives for bubble CPAP at both central and district hospitals to better understand key factors that enable effective caregiver engagement in Malawi. This was a descriptive qualitative study employing secondary analysis of 46 health care worker in-depth interviews to understand their experiences on using Hospital (QECH) and three district level hospitals in Mulanje, Chikwawa and Phalombe in Southern Malawi. This was a part of a larger study to understand barriers and facilitators to implementing neonatal innovations in resource-constrained hospitals. Interviews were thematically analysed in Nvivo 10 (QSR International). Health workers were purposively selected to include nurses, clinicians and district health management involved in the use of bubble CPAP. Emerging issues included caregiver fears around the bubble CPAP machine as potentially harmful to their new-borns and how inadequate or no information provided to caregivers exacerbated knowledge gaps and was associated with refusal of care.