Infrastructure and Equipment

Impact of Continuous Positive Airway Pressure (CPAP) machines on neonatal survival in a teaching hospital in Rwanda.

The mortality rate on the neonatal unit at a large referral hospital in Rwanda in 2019/20 was 23%, using neonatal admissions as a denominator. Until March 2022 there were no factory-made continuous positive airway pressure (CPAP) machines for use in neonates with respiratory difficulties. Improvised techniques were used. Following receipt of ten factory-made CPAP machines the neonatal mortality rate in the unit appeared to decrease. We had, therefore, the very rare opportunity to compare neonatal survival before and after ‘factory-made’ CPAP machines were available for all neonates for whom CPAP was indicated.

We used both data from registers and patient files for neonatal survival and assessment scores for nurses on their knowledge and skills in use of CPAP machines.  In doing so we found that there was an increase in survival 18.45, adjusting for birthweight. Furthermore, nurses all scored over 80% in the post training assessment. 

We concluded that ‘factory-made’ CPAP machines, combined with training on their use to all nurses working in neonatal units, can substantially reduce neonatal mortality in a teaching hospital in Rwanda. We are currently looking at the added benefit of providing caffeine to neonates with respiratory symptoms. Watch this spot.