Oxygen is life.
Too many newborns die because they are born too early, too small or too sick to breathe properly on their own. Simple medical devices can assist newborn breathing until an infant can breathe on his or her own. However, these devices are often out of reach for small clinics and hospitals.
The Pumani bCPAP was designed to meet this need for Malawi and is now widely available through Maternova. We had a few questions about post-research phases of the Pumani bubble CPAP which we posed to Jocelyn Brown, inventor of the Pumani bCPAP. Here is the brief interview:
Do tell us where the 'densest' concentration of Pumani CPAPs is in in the globe and how many infants are being treated per month (or day or week or year):
We have over 100 Pumani bCPAP devices in use in Malawi, due to our partnership with the Rice 360 Institute for Global Health. Rice 360, along with partners at Queen Elizabeth Central Hospital, the Malawi Ministry of Health, Texas Children’s Hospital, and 3 rd Stone Design, conducted the initial clinical study of the Pumani bCPAP in Malawi. Following the results of this study, which showed that neonatal mortality was reduced by 27% with bCPAP therapy, the partners began a countrywide training and distribution program to all central and district hospitals in Malawi. More recently, Rice 360 and partners have expanded the Pumani to the Christian Health Association of Malawi (CHAM) hospitals, so the Pumani is in a majority of the public and faith-based hospitals in the country. (JB)
Over 3,000 newborns in Malawi have received Pumani bCPAP therapy since the clinical study in 2012.
We understand that there are specific champions of the Pumani bCPAP in Malawi who maintain the training and transfer of knowledge about the device-- can you tell us how that came to be?
As described above, the partners in Malawi first proposed the idea to develop a low-cost, robust bCPAP for Queen Elizabeth Central Hospital (QECH) to Rice 360, and these partners provided ongoing feedback during the Pumani design and development. The clinical study was also conducted at QECH. Since the clinical study, partners at the Malawi Ministry of Health, who have already conducted countrywide training on oxygen therapy and management of newborn respiratory conditions, became the champions of the national CPAP training in Malawi, and worked closely with the Rice 360 and QECH staff to conduct the Pumani training and distribution. (JB)
When you are introducing the bubble CPAP to a nurse, midwife or physician who has never used such a device before, how long does it take for him/her to become proficient in treating and infant?
For the Malawi trainings, and trainings conducted in other countries, the Pumani training agenda is typically 1.5-2 days. This may vary, depending on the skill level of the trainees, the time available for training, and the number of trainees. But this training program covers more than just the Pumani bCPAP assembly and use – it includes diagnosing newborn respiratory conditions and respiratory distress, identifying patients for bCPAP therapy, what bCPAP therapy is and why it’s beneficial, and how to monitor and wean patients on bCPAP.
It probably takes some time following the training for a clinician to feel comfortable treating a patient with the Pumani. In Malawi, Rice 360 and partners have set up a clinician mentoring program, so that new users can be mentored and supported by users who have been using the Pumani for years and are more comfortable. (JB)
What are the most common questions that your team gets in the training sessions for the Pumani?
The most common questions are usually related to the use of the Pumani – how to increase or decrease therapy, how to adjust the flow settings, how to maintain and repair the Pumani if any issue arises, etc. Our goal with the user manual and training materials is to make sure the assembly, use, and maintenance of the Pumani are as simple and understandable as possible, but there’s only so much information that can be conveyed via print or video. The application of the Pumani to the patient is still most easily conveyed via actual use by clinicians.
What is the optimal training scenario (and continuing education) for the bubble CPAP?
The optimal initial training scenario for the Pumani is a training prepared and conducted by local clinicians. As much as possible, we aim to support local users in their initial trainings – whether that’s providing training materials, training videos, explaining how other trainings have been organized and run, etc. In certain cases, we can offer in-person training provided by 3 rd Stone Design staff, but even then, much of the training is led by a clinician familiar with bCPAP, and we provide the training on the Pumani assembly and use. (JB)
For continuing training, also optimal if local clinicians can provide this training and ensure that current users and new users are comfortable and familiar with the Pumani.
Maternova is working to accelerate awareness and uptake of the Pumani bCPAP and will work with partners to ensure long-standing support and continuing education on this low-cost, rugged device.
Interview by Meg Wirth, Maternova
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