{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T13:19:26Z","timestamp":1785331166350,"version":"3.55.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T00:00:00Z","timestamp":1714348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>According to Bangladesh Demographic and Health Survey (2022), neonatal mortality, comprising 67% of under-5 deaths in Bangladesh, is significantly attributed to prematurity and low birth weight (LBW), accounting for 32% of neonatal deaths. Respiratory distress syndrome (RDS) is a prevalent concern among preterm and LBW infants, leading to substantial mortality. The World Health Organization (WHO) recommends bubble continuous positive airway pressure (bCPAP) therapy, but the affordability and accessibility of conventional bCPAP devices for a large number of patients become major hurdles in Bangladesh due to high costs and resource intensiveness. The Vayu bCPAP, a simple and portable alternative, offers a constant flow of oxygen-enriched, filtered, humidified, and pressurized air. Our study, conducted in five health facilities, explores the useability, acceptability, and perceived treatment outcome of Vayu bCPAP in the local context of Bangladesh.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A qualitative approach was employed in special care newborn units (SCANUs) of selected facilities from January to March 2023. Purposive sampling identified nine key informants, 40 in-depth interviews with service providers, and 10 focus group discussions. Data collection and analysis utilized a thematic framework approach led by trained anthropologists and medical officers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Service providers acknowledged Vayu bCPAP as a lightweight, easily movable, and cost-effective device requiring minimal training. Despite challenges such as consumable shortages and maintenance issues, providers perceived the device as user-friendly, operable with oxygen cylinders, and beneficial during referral transportation. Treatment outcomes indicated effective RDS management, reduced hospital stays, and decreased referrals. Though challenges existed, healthcare providers and facility managers expressed enthusiasm for Vayu bCPAP due to its potential to simplify advanced neonatal care delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The Vayu bCPAP device demonstrated useability, acceptability, and favorable treatment outcomes in the care of neonates with RDS. However, sustained quality service necessitates continuous monitoring, mentoring and retention of knowledge and skills. Despite challenges, the enthusiasm among healthcare providers underscores the potential of Vayu bCPAP to save lives and simplify neonatal care delivery. Development of Standard Operating procedure on Vayu bCPAP is required for systematic implementation. Further research is needed to determine how the utilization of Vayu bCPAP devices enhances accessibility to efficient bCPAP therapy for neonates experiencing RDS.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2024.1359406","type":"journal-article","created":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T04:32:05Z","timestamp":1714365125000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Vayu bubble continuous positive airway pressure is a promising solution with favorable treatment outcomes for respiratory distress syndrome in newborns: a qualitative study in Bangladesh"],"prefix":"10.3389","volume":"12","author":[{"given":"Goutom","family":"Banik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. A.","family":"Halim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abu Sayeed","family":"Md. Abdullah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irtifa","family":"Oishee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"Boyce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjoy Kumer","family":"Dey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Abdul","family":"Mannan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadeka Choudhury","family":"Moni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Kamrul Hassan","family":"Shabuj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismat","family":"Jahan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rumpa Mani","family":"Chowdhury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharmin","family":"Afroze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Wall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammod","family":"Shahidullah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,4,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"S2","DOI":"10.1186\/1742-4755-10-S1-S2","article-title":"Born too soon: the global epidemiology of 15 million preterm births","volume":"10","author":"Blencowe","year":"2013","journal-title":"Reprod Health"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s12889-022-13629-4","article-title":"Clusters of preterm live births and respiratory distress syndrome-associated neonatal deaths: spatial distribution and cooccurrence patterns","volume":"22","author":"Marinonio","year":"2022","journal-title":"BMC Public Health"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e0159388","DOI":"10.1371\/journal.pone.0159388","article-title":"When, where, and why are babies dying? Neonatal death surveillance and review in Bangladesh","volume":"11","author":"Halim","year":"2016","journal-title":"PLoS One"},{"key":"B4","volume-title":"New global estimates on preterm birth published","year":"2018"},{"key":"B5","doi-asserted-by":"publisher","first-page":"2","DOI":"10.19080\/AJPN.2020.08.555808","article-title":"A low-cost Venturi ambient air-oxygen blender for neonatal oxygen therapy","volume":"9","author":"Kamyar","year":"2020","journal-title":"Acad J Pediatr Neonatol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1542\/peds.2009-2959","article-title":"Neonatal outcomes of extremely preterm infants from the NICHD neonatal research network","volume":"126","author":"Stoll","year":"2010","journal-title":"Pediatrics"},{"key":"B7","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1590\/S0021-75572008000400004","article-title":"Perinatal factors associated with early deaths of preterm infants born in Brazilian network on neonatal research centers","volume":"84","author":"Almeida","year":"2008","journal-title":"J Pediatr (Rio J)"},{"key":"B8","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1891\/0730-0832.22.6.7","article-title":"Physiologic effects of CPAP: application and monitoring","volume":"22","author":"Irwin Sherman","year":"2003","journal-title":"Neonatal Netw"},{"key":"B9","doi-asserted-by":"publisher","first-page":"48","DOI":"10.19080\/AJPN.2020.08.555808","article-title":"A low-cost Venturi ambient air-oxygen blender for neonatal oxygen therapy","volume":"8","author":"Mollazadeh-Moghaddam","year":"2020","journal-title":"Acad J Pediatr Neonatol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1572","DOI":"10.4187\/respcare.08948","article-title":"Evaluation of a bubble CPAP system for low resource settings","volume":"66","author":"Dundek","year":"2021","journal-title":"Respir Care"},{"key":"B11","article-title":"Vayu. Engineering Healthcare Solutions for Global Access","year":""},{"key":"B12","first-page":"4","article-title":"Qualitative, multimethod, and mixed methods research","volume-title":"International Encyclopedia of Education","author":"Mihas","year":"2023"},{"key":"B13","doi-asserted-by":"publisher","first-page":"e029963","DOI":"10.1136\/bmjopen-2019-029963","article-title":"Introduction and adoption of innovative invasive procedures and devices in the NHS: an in-depth analysis of written policies and qualitative interviews (the INTRODUCE study protocol)","volume":"9","author":"Cousins","year":"2019","journal-title":"BMJ open"},{"key":"B14","doi-asserted-by":"publisher","first-page":"296","DOI":"10.7326\/0003-4819-140-4-200402170-00012","article-title":"Medical device regulation: an introduction for the practicing physician","volume":"140","author":"Maisel","year":"2004","journal-title":"Ann Intern Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1111\/j.1369-7625.2007.00464.x","article-title":"Issues and challenges of involving users in medical device development","volume":"11","author":"Bridgelal Ram","year":"2008","journal-title":"Health Expect"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e0269147","DOI":"10.1371\/journal.pone.0269147","article-title":"Feasibility of a novel ultra-low-cost bubble CPAP (bCPAP) system for neonatal respiratory support at Muhimbili National Hospital, Tanzania","volume":"17","author":"Tayler","year":"2022","journal-title":"PLoS One"},{"key":"B17","first-page":"158","article-title":"Feasibility study of a low-cost bubble CPAP system in a neonatal medium care unit in Belgium","volume":"25","author":"Vanbinst","year":"2023","journal-title":"Belgian J Paediatr"},{"key":"B18","doi-asserted-by":"publisher","first-page":"e0252718","DOI":"10.1371\/journal.pone.0252718","article-title":"Experiences with implementation of continuous positive airway pressure for neonates and infants in low-resource settings: a scoping review","volume":"16","author":"Dada","year":"2021","journal-title":"PLoS One"},{"key":"B19","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1093\/tropej\/fmu025","article-title":"Is continuous positive airway pressure a feasible treatment modality for neonates with respiratory distress syndrome in a rural district hospital?","volume":"60","author":"Hendriks","year":"2014","journal-title":"J Trop Pediatr"},{"key":"B20","doi-asserted-by":"publisher","first-page":"F495","DOI":"10.1136\/archdischild-2013-305519","article-title":"Efficacy and safety of bubble CPAP in neonatal care in low and middle income countries: a systematic review","volume":"99","author":"Martin","year":"2014","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"B21","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1542\/peds.2019-0668","article-title":"Neonatal CPAP for respiratory distress across Malawi and mortality","volume":"144","author":"Carns","year":"2019","journal-title":"Pediatrics"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12887-018-1311-8","article-title":"Healthcare workers\u2019 views on the use of continuous positive airway pressure (CPAP) in neonates: a qualitative study in Andhra Pradesh, India","volume":"18","author":"Dewez","year":"2018","journal-title":"BMC Pediatr"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12913-019-4364-y","article-title":"Bubble CPAP and oxygen for child pneumonia care in Malawi: a CPAP IMPACT time motion study","volume":"19","author":"Sessions","year":"2019","journal-title":"BMC Health Serv Res"},{"key":"B24","doi-asserted-by":"publisher","first-page":"964","DOI":"10.1016\/S2213-2600(19)30243-7","article-title":"Bubble continuous positive airway pressure for children with high-risk conditions and severe pneumonia in Malawi: an open label, randomised, controlled trial","volume":"7","author":"McCollum","year":"2019","journal-title":"Lancet Respir Med"},{"key":"B25","article-title":"Children: improving survival and wellbeing","year":"2020"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1649","DOI":"10.1016\/S0140-6736(17)30312-4","article-title":"The evolution of modern respiratory care for preterm infants","volume":"389","author":"Owen","year":"2017","journal-title":"Lancet"},{"key":"B27","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1093\/tropej\/fmw085","article-title":"An innovative air-oxygen blender for continuous positive airway pressure support in resource-poor locations: a feasibility study","volume":"63","author":"Daga","year":"2016","journal-title":"J Trop Pediatr"},{"key":"B28","article-title":"Medical Device Regulations: Global Overview and Guiding Principles","author":"Cheng","year":""},{"key":"B29","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1108\/JQME-07-2016-0029","article-title":"Dependability-based maintenance optimization in healthcare domain","volume":"24","author":"Mahfoud","year":"2018","journal-title":"J Qual Maint Eng"},{"key":"B30","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1097\/JCE.0000000000000538","article-title":"Medical equipment maintenance management system: review and analysis","volume":"47","author":"Khider","year":"2022","journal-title":"J Clin Eng"},{"key":"B31","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1001\/jama.282.9.867","article-title":"Impact of formal continuing medical education: do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes?","volume":"282","author":"Davis","year":"1999","journal-title":"JAMA"},{"key":"B32","doi-asserted-by":"crossref","first-page":"II-2","DOI":"10.1097\/00005650-200108002-00002","article-title":"Changing provider behavior: an overview of systematic reviews of interventions","volume":"39","author":"Grimshaw","year":"2001","journal-title":"Med Care"},{"key":"B33","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1108\/JQME-11-2017-0082","article-title":"Influential factors on medical equipment maintenance management: in search of a framework","volume":"25","author":"Bahreini","year":"2019","journal-title":"J Qual Maint Eng"},{"key":"B34","doi-asserted-by":"publisher","first-page":"123","DOI":"10.4172\/2475-7586.1000123","article-title":"Maintenance practice, causes of failure and risk assessment of diagnostic medical equipment","volume":"2","author":"Kutor","year":"2017","journal-title":"J Biomed Eng Med Dev"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1359406\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T04:32:11Z","timestamp":1714365131000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1359406\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,29]]},"references-count":34,"alternative-id":["10.3389\/fped.2024.1359406"],"URL":"https:\/\/doi.org\/10.3389\/fped.2024.1359406","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,29]]},"article-number":"1359406"}}