An evaluation of oxygen therapy and respiratory support practices among hospitals in the African Neonatal Network
Keywords:
Neonatal care; Oxygen therapy; Respiratory support; Continuous Positive Airway Pressure (CPAP); Neonatal mortality; Pulse oximetry; Surfactant therapy; Resource-limited settings.Abstract
Background: Neonatal respiratory support, including oxygen therapy, is critical for reducing neonatal mortality in sub- Saharan Africa, where neonatal outcomes remain poor due to infrastructure and resource limitations.
Methods: Fourteen hospitals in the African Neonatal Network responded to an annual facility survey and a health facility survey co-developed by faculty in the African Neonatal Network and Vermont Oxford Network. All analyses use descriptive statistics.
Results: While oxygen was universally available, only 78% of hospitals had pulse oximeters and 21% had blood gas analysis capabilities. CPAP was available in 77% of hospitals, but only 36% had surfactant and 14% offered blended oxygen to all neonates. Protocols for oxygen use varied, with just 64% having target saturation guidelines and 43% using pulse oximeter alarms. Oxygen supply interruptions were common, and equipment gaps, like compressed air and monitoring tools, were prevalent.
Conclusion: Major deficiencies in neonatal respiratory care and oxygen use persist across ANN hospitals, including limited access to monitoring tools, standardized protocols, and advanced therapies. Addressing these gaps through infrastructure investments, protocol development and standardization, training, and supply chain improvements is essential to advancing neonatal care through
optimal respiratory support in resource-limited African settings.
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