Implementation Assessment of the Feasibility, Acceptability and Sustainability of VAYU Bubble Continuous Positive Airway Pressure (bCPAP) for Neonatal Respiratory Support in Uganda (2026)

Respiratory distress is a leading cause of morbidity and mortality among preterm and small newborns in Uganda, yet access to affordable and appropriate respiratory support remains limited in many health facilities. To inform decisions on wider adoption of innovative neonatal technologies, this implementation research assessed the feasibility, acceptability, and sustainability of the VAYU Bubble Continuous Positive Airway Pressure (bCPAP) system in five health facilities supported by the Saving Women and Preterm Babies (SWAP) Project in Uganda.

The study employed a mixed-methods design combining analysis of routine clinical data from 1,185 newborns managed using VAYU bCPAP between February 2023 and August 2024 with qualitative interviews and discussions involving 82 healthcare providers and project stakeholders.

Findings indicate that VAYU bCPAP is highly acceptable to health workers due to its ease of use, portability, affordability relative to conventional CPAP systems, ability to deliver blended humidified oxygen, and perceived contribution to improved neonatal outcomes. Among newborns with documented outcomes, 63.2% were successfully weaned from CPAP support, while use of the device was associated with reduced referrals and improved survival among infants with respiratory distress. Key facilitators included health worker training, mentorship, supportive supervision, device portability, and alignment with national newborn care guidelines. Major barriers included dependence on oxygen availability, supply chain challenges for consumables and spare parts, device assembly complexities, and high turnover of trained staff.

The study concludes that VAYU bCPAP is a feasible and promising option for neonatal respiratory support in resource-constrained settings, provided that investments are made in oxygen systems, health worker capacity building, maintenance mechanisms, and sustainable procurement pathways. These findings provide important evidence to support policy dialogue and scale-up of affordable newborn respiratory care innovations in Uganda.