Healthcare Professionals’ Training, Experiences, and Management Outcomes in Neonatal Respiratory Care in Ghana : A Qualitative Investigation

Abstract

Background: In environments with limited resources, neonatal respiratory conditions continue to be a leading cause of death. Non-invasive breathing techniques like Continuous Positive Airway Pressure (CPAP) have been shown to be successful; nevertheless, systemic, institutional, and training-related obstacles hinder their use in sub-Saharan Africa. This study explores the lived experiences, level of training, and perceived outcomes of healthcare personnel involved in neonatal respiratory care at the Greater Accra Regional Hospital (GARH) in Ghana. Methods: In-depth semi-structured interviews with 15 healthcare professionals, including doctors, nurses, respiratory therapists, and a clinical engineer, were conducted using a qualitative phenomenology approach. The selection of participants was based on their involvement in newborn care. MAXQDA software was used to analyze the data thematically, and the results were interpreted using a multi-theoretical framework that included social cognitive theory, human factors theory, and role theory. Findings: To provide clarity and explanation of the presentation,four major themes were generated from the results: (1) Structural and Systemic Constraints in Neonatal Respiratory Care, (2) Training, Competency, and Capacity Building, (3) Outcome on Neonatal Respiratory Care (4) Institutional Support and System-Level. Each theme includes a variety of sub-themes that represent the different yet interconnected aspects of neonatal respiratory care in the facility. The main issues raised by the participants were inadequate referral and transport mechanisms, a lack of formal CPAP training, overburden on available equipment, and inadequate equipment. Despite these challenges, staff members showed a strong sense of internal motivation and a dedication to enhancing newborn outcomes, frequently using peerled training and relying on improvisation. Conclusion: The results highlight the urgent need for targeted training initiatives, improved infrastructure support, and context-adapted CPAP implementation strategies in neonatal units across Ghana. In situations with limited resources, addressing workforce development and strengthening institutional support structures can greatly improve the standard of neonatal respiratory care.