ReviewPublic health reviews2020
Barriers and facilitators to implementing bubble CPAP to improve neonatal health in sub-Saharan Africa: a systematic review.
Review in Public health reviews, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 4 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
33 citing papers in PubMed, 4 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- The Care of Preterm and Term Newborns with Respiratory Conditions: A Systematic Synthesis of Evidence from Low- and Middle-Income Countries.Neonatology · 2025Pooled it
- Continuous Positive Airway Pressure (CPAP) for severe pneumonia in low- and middle-income countries: A systematic review of contextual factors.Journal of global health · 2022Pooled it
- Barriers and facilitators of facility-based kangaroo mother care in sub-Saharan Africa: a systematic review.BMC pregnancy and childbirth · 2021Pooled it
- The Impact of Social Support and Pregnancy on Subjective Well-Being: A Systematic Review.Frontiers in psychology · 2021Pooled it
- Acceptability of immediate CPAP for preterm infants in the delivery room to mothers, caregivers and healthcare workers in a low-resource setting: a qualitative study.BMC pediatrics · 2025Trial
- Article
- Medical gases and long-term oxygen therapy: reducing the chronic obstructive pulmonary disease burden in aging populations in Sub-Saharan Africa.Medical gas research · 2026Review
- Patient and caregiver perceptions of oxygen therapy in facility-based settings for acute hypoxemic conditions: a scoping review.Journal of global health · 2025Article
- Optimising neonatal bubble continuous positive airway pressure: A Somaliland quality initiative.African journal of primary health care & family medicine · 2025Article
- Article
- Establishment of a neonatal nursery in a rural district hospital in Malawi: a retrospective review of neonatal outcomes in Neno District Hospital (2014-2021).BMC pediatrics · 2025Article
- Article
- Sustainability of an evidence-based intervention supporting transition to independent care for youth living with HIV in Kenya.PLOS global public health · 2025Article
- Feasibility and integration of a novel bubble CPAP system into a public referral PICU in Mysuru, India.Frontiers in pediatrics · 2025Article
- Article
- Evaluation of a novel reprocessed bCPAP system on sepsis rates among preterm neonates with respiratory distress: a randomized controlled trial.Frontiers in pediatrics · 2025Article
- Evaluating the Feasibility of a Nonelectric Bubble CPAP System in the NICU of a Philippine Regional Referral Hospital: A Qualitative Study.International journal of pediatrics · 2025Article
- A survey on the use of continuous positive airway pressure in newborn care in Kenya in 2017-2018.PloS one · 2025Article
- Outcome of Nasal continuous positive airway pressure in neonates: A cross-sectional study.Pakistan journal of medical sciences · 2024Article
- Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBubble continuous positive airway pressure (CPAP) has been shown to be effective in supporting breathing in newborns with respiratory distress. The factors that influence implementation in resource-constrained settings remain unclear. The objective of this review is to evaluate the barriers and facilitators of CPAP implementation for newborn care at sub-Saharan African health facilities and how different facility levels and types of bubble CPAP systems may impact utilization.
methodsA systematic search (database inception to July 2019) was performed on MEDLINE Ovid, EMBASE, CINAHL, The Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), the WHO Regional Database for Africa, African Index Medicus (AIM), African Journals Online, grey literature and the references of relevant articles. Studies that met the inclusion criteria (primary research, bubble CPAP implementation with neonates ≤ 28 days old at a health facility in sub-Saharan Africa) were included in the review and assessed with National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) quality assessment tools. The review protocol was published to PROSPERO (CRD42018116082).
resultsSeventeen studies were included in the review. Reliable availability of equipment, effectively informing and engaging caregivers and staffing shortages were frequently mentioned barriers to the implementation of bubble CPAP. Understaffed neonatal units and high turnover of nurses and doctors compromised effective training. Provider-to-provider clinical mentorship models as well as affordability and cost-effectiveness of innovative bubble CPAP systems were identified as frequently mentioned facilitators of implementation.
conclusionsWith a strong recommendation by the World Health Organization for its use with premature infants with respiratory distress, it is important to understand the barriers and facilitators that can inform the implementation of bubble CPAP. More research is needed into health system factors that can support or impede the use of this potentially promising intervention.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.