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Table 2 Summary of barriers and facilitators by hospital level

From: Scaling up newborn care technologies from tertiary- to secondary-level hospitals in Malawi: an implementation case study of health professional perspectives on bubble CPAP

  Barriers Facilitators
Tertiary hospital • Disagreements between clinicians and nurses (authority and training)
• Insufficient availability of CPAP machines
• Frequent use of strengthened training and experience
• Nurses dedicated to nursery
• Reliable availability of physicians
• Reliable availability of electricity
District hospitals • Lack of reliable electricity
• Training gaps exacerbated by staff rotation
• Severe staffing shortages
• Unsupportive environment to strengthen self-efficacy
• Poor systems of accountability
• Empowering nurses as decision-makers and initiators
• Involving caretakers to help monitor
• Availability of CPAP machines