Perceptions and experiences of Congolese midwives implementing a low-cost battery-operated heart rate meter during newborn resuscitation
Background900,000 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&#...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.943496/full |
| _version_ | 1828384882809634816 |
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| author | Madeline Thornton Daniel Ishoso Adrien Lokangaka Sara Berkelhamer Melissa Bauserman Joar Eilevstjønn Pooja Iyer Beena D. Kamath-Rayne Eric Mafuta Helge Myklebust Janna Patterson Antoinette Tshefu Carl Bose Jackie K. Patterson |
| author_facet | Madeline Thornton Daniel Ishoso Adrien Lokangaka Sara Berkelhamer Melissa Bauserman Joar Eilevstjønn Pooja Iyer Beena D. Kamath-Rayne Eric Mafuta Helge Myklebust Janna Patterson Antoinette Tshefu Carl Bose Jackie K. Patterson |
| author_sort | Madeline Thornton |
| collection | DOAJ |
| description | Background900,000 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.MethodsAfter 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.ResultsEach 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.ConclusionMidwives 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. |
| first_indexed | 2024-12-10T05:11:09Z |
| format | Article |
| id | doaj.art-b2d295be2fae4a3284884325b191a722 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-10T05:11:09Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-b2d295be2fae4a3284884325b191a7222022-12-22T02:01:06ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-09-011010.3389/fped.2022.943496943496Perceptions and experiences of Congolese midwives implementing a low-cost battery-operated heart rate meter during newborn resuscitationMadeline Thornton0Daniel Ishoso1Adrien Lokangaka2Sara Berkelhamer3Melissa Bauserman4Joar Eilevstjønn5Pooja Iyer6Beena D. Kamath-Rayne7Eric Mafuta8Helge Myklebust9Janna Patterson10Antoinette Tshefu11Carl Bose12Jackie K. Patterson13Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesSchool of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of CongoSchool of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of CongoDepartment of Pediatrics, University of Washington, Seattle, WA, United StatesDepartment of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesStrategic Research Department, Laerdal Medical, Stavanger, NorwayRTI International, Durham, NC, United StatesAmerican Academy of Pediatrics, Itasca, IL, United StatesSchool of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of CongoStrategic Research Department, Laerdal Medical, Stavanger, NorwayRTI International, Durham, NC, United StatesSchool of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of CongoDepartment of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesDepartment of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesBackground900,000 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.MethodsAfter 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.ResultsEach 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.ConclusionMidwives 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.https://www.frontiersin.org/articles/10.3389/fped.2022.943496/fullneonatal resuscitationHelping Babies Breatheelectronic heart rate monitoringlow-income countries (LMICs)stillbirth |
| spellingShingle | Madeline Thornton Daniel Ishoso Adrien Lokangaka Sara Berkelhamer Melissa Bauserman Joar Eilevstjønn Pooja Iyer Beena D. Kamath-Rayne Eric Mafuta Helge Myklebust Janna Patterson Antoinette Tshefu Carl Bose Jackie K. Patterson Perceptions and experiences of Congolese midwives implementing a low-cost battery-operated heart rate meter during newborn resuscitation Frontiers in Pediatrics neonatal resuscitation Helping Babies Breathe electronic heart rate monitoring low-income countries (LMICs) stillbirth |
| title | Perceptions and experiences of Congolese midwives implementing a low-cost battery-operated heart rate meter during newborn resuscitation |
| title_full | Perceptions and experiences of Congolese midwives implementing a low-cost battery-operated heart rate meter during newborn resuscitation |
| title_fullStr | Perceptions and experiences of Congolese midwives implementing a low-cost battery-operated heart rate meter during newborn resuscitation |
| title_full_unstemmed | Perceptions and experiences of Congolese midwives implementing a low-cost battery-operated heart rate meter during newborn resuscitation |
| title_short | Perceptions and experiences of Congolese midwives implementing a low-cost battery-operated heart rate meter during newborn resuscitation |
| title_sort | perceptions and experiences of congolese midwives implementing a low cost battery operated heart rate meter during newborn resuscitation |
| topic | neonatal resuscitation Helping Babies Breathe electronic heart rate monitoring low-income countries (LMICs) stillbirth |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.943496/full |
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