Dr Helen Nabwera, Senior Clinical Research Associate at CMNH and honorary Consultant Paediatrician at Alder Hey Children's Hopsital, is awarded a prize for the best poster in the International Child Health Group category at the Royal College of Paediatrics and Child Health's conference. Dr Nabwera’s winning poster presents preliminary results from research she led on "Assessing the use of continuous positive airway pressure in newborn care in Kenya." This work was based on the study protocol developed by her predecessor, Dr Juan Emmanuel Dewez. The judges awarded the prize based on Dr Nabwera and her team’s very good quality work, well-structured poster and ability to answer questions from conference participants comprehensively.
Dr Nabwera’s research works towards ending preventable newborn deaths. Severe breathing difficulties are a common cause of newborn deaths in low- and middle-income countries (LMICs), where breathing support has been inaccessible due to the high costs of implementation. Technological innovation has recently supported the development of a simple and more affordable means of providing breathing support to these newborns: Continuous Positive Airway Pressure (CPAP). It saves lives and is increasingly being used in LMICs with the potential for large scale implementation.
In Kenya, the Ministry of Health recommends the use of CPAP only in hospitals providing a high level of newborn care (photos below). Our study aimed to describe the operational aspects of CPAP use in newborn care in Kenya and explore barriers and enablers of implementation.
The key findings were that the infrastructure and human resource to support the appropriate use of CPAP in newborn care was inadequate in the public sector, where the workload was greatest. However, where implementation worked, the lives saved were a great motivator for staff and carers.
Our recommendations are that future implementation strategies should incorporate sustainability measures for CPAP infrastructure, staff training and retention, as well as monitoring and evaluation. In addition, the implementation of CPAP needs to be in the context of overall improvements in essential newborn care where the basics are also prioritised.
Next steps: we plan to share this information with the Ministry of Health in Kenya and work with them in strengthening future implementation strategies for this life-saving intervention that can cause more harm than good if used incorrectly.
This study was funded by the UK Department for International Development in Kenya.
Dr Helen Nabwera, Senior Clinical Research Associate at CMNH:
Helen is a consultant General Paediatrician with clinical and research experience from sub-Saharan Africa and the UK. Her research focuses on newborn health and designing and testing innovative strategies that incorporate infant and early child nutrition, for reducing mortality in the low birth weight infants who are at a particular risk of poor outcomes.