Evidence map›Paper›PMID 35761203›Full record

ArticleBMC pediatrics2022

Challenges and recommendations to improve implementation of phototherapy among neonates in Malawian hospitals.

Mai-Lei Woo Kinshella, Sangwani Salimu, Brandina Chiwaya, Felix Chikoti, Lusungu Chirambo, Ephrida Mwaungulu, Mwai Banda, Tamanda Hiwa, Marianne Vidler, Elizabeth M Molyneux and 5 more

Open access · goldAbstract read
In one paragraph

Article in BMC pediatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
3.0field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
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  3. Article
  4. Article
  5. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 4 institutions in 2 countries.

Mai-Lei Woo KinshellaDepartment of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada.
Sangwani SalimuDepartment of Health Systems and Policy, School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
Brandina ChiwayaDepartment of Pediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
Felix ChikotiDepartment of Pediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
Lusungu ChiramboDepartment of Pediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
Ephrida MwaunguluDepartment of Pediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
Mwai BandaDepartment of Pediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
Tamanda HiwaDepartment of Pediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
Marianne VidlerDepartment of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada.
Elizabeth M MolyneuxDepartment of Pediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
Queen DubeQueen Elizabeth Central Hospital, Pediatrics, Blantyre, Malawi.
Joseph Mfutso-BengoDepartment of Health Systems and Policy, School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
David M GoldfarbDepartment of Pathology and Laboratory Medicine, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada.
Kondwani KawazaDepartment of Pediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
Alinane Linda Nyondo-MipandoDepartment of Health Systems and Policy, School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi. lmipando@kuhes.ac.mw.
Kamuzu Central Hospital · MWKamuzu University of Health SciencesUniversity of British Columbia · CAQueen Elizabeth Central Hospital · MW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSevere neonatal jaundice can result in long term morbidities and mortality when left untreated. Phototherapy is the main-stay intervention for treating moderate jaundice and for prevention of the development of severe jaundice. However, in resource-limited health care settings, phototherapy has been inconsistently used. The objective of this study is to evaluate barriers and facilitators for phototherapy to treat neonatal jaundice at Malawian hospitals.

methodsWe conducted a convergent mixed-method study comprised of a facility assessment and qualitative interviews with healthcare workers and caregivers in southern Malawi. The facility assessment was conducted at three secondary-level hospitals in rural districts. In-depth interviews following a semi-structured topic guide were conducted at a district hospital and a tertiary-level hospital. Interviews were thematically analysed in NVivo 12 software (QSR International, Melbourne, Australia).

resultsThe facility assessment found critical gaps in initiating and monitoring phototherapy in all facilities. Based on a total of 31 interviews, participants identified key challenges in diagnosing neonatal jaundice, counselling caregivers, and availability of infrastructure. Participants emphasized the need for transcutaneous bilirubinometers to guide treatment decisions. Caregivers were sometimes fearful of potential harmful effects of phototherapy, which required adequate explanation to mothers and family members in non-medical language. Task shifting and engaging peer support for caregivers with concerns about phototherapy was recommended.

conclusionImplementation of a therapeutic intervention is limited if accurate diagnostic tests are unavailable. The scale up of therapeutic interventions, such as phototherapy for neonatal jaundice, requires careful holistic attention to infrastructural needs, supportive services such as laboratory integration as well as trained human resources.

Indexed as

Jaundice, NeonatalHealth PersonnelHospitals, DistrictHumansInfant, NewbornPhototherapyTertiary Care CentersNeonatal jaundiceNeonatesPhototherapyPreterm births

Identifiers

PMID35761203
PMCPMC9235141
OpenAlexW4283592192

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.