Ayesiga Innocent, Magala Primrose, Ediamu Tom Didimus, El Diwany Hana, Yeung Ian Ly, Wasomoka Alex, Muwonge Henry, Musoke Phillip, Musiime Elias, Tumwesigye Abraham, Atwau Pius, Atwijukire Noreen, Ndyabawe Iddi, Musika Anne Mpaire, Patel Himanshu I, Malik Aeesha Nj, Bwaga Ibrahim, Nakacubo Sheba Gitta
Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda
Research Department, Ubora Foundation Africa, Kampala, Uganda.
BMJ Paediatr Open. 2025 Aug 19;9(1):e003104. doi: 10.1136/bmjpo-2024-003104.
Retinopathy of prematurity (ROP) is a significant cause of blindness and visual impairment in preterm infants globally, particularly in low-income and middle-income countries. ROP is associated with prematurity, and with the increase in the survival of preterm infants, its global burden continues to rise. However, there is limited information available on health workers' perspectives regarding ROP in Uganda.
This qualitative study explored health workers' experiences regarding ROP in the neonatal intensive care unit (NICU) at Hoima Regional Referral Hospital. This study involved in-depth interviews with eight health workers working in the NICU. We examined individual, facility and national factors that could impact the health workers' perspectives on ROP at the hospital. The data obtained were transcribed and coded, and themes were generated for further analysis.
We identified key barriers and facilitators to effective ROP care. Four major themes emerged from the analysis: (1) Knowledge and awareness of ROP, (2) Challenges and limitations in implementing the ROP screening programme, (3) Training and guidelines for ROP screening and treatment and (4) Recommendations for ROP prevention screening and management. ROP awareness, knowledge of ROP and witchcraft and ROP were identified as specific subthemes under the knowledge and awareness of ROP theme.
This study reveals significant gaps in health workers' knowledge and awareness of ROP. Limited access to essential equipment and specialised personnel may further limit ROP screening capacity. We suggest implementing a multidisciplinary team approach, continuous professional development and establishing national ROP guidelines. We recommend developing a formal training structure and syllabus for ROP screening. The training can enhance task shifting among health workers in areas without specialised health workers. Addressing the identified barriers is crucial for improving the care and outcomes for preterm infants in Uganda and similar settings.
早产儿视网膜病变（ROP）是全球早产儿失明和视力损害的一个重要原因，在低收入和中等收入国家尤为如此。ROP与早产相关，随着早产儿存活率的提高，其全球负担持续上升。然而，关于乌干达卫生工作者对ROP看法的信息有限。
这项定性研究探讨了霍伊马地区转诊医院新生儿重症监护病房（NICU）卫生工作者对ROP的经验。该研究对在NICU工作的八名卫生工作者进行了深入访谈。我们考察了可能影响医院卫生工作者对ROP看法的个人、机构和国家因素。所获数据进行了转录和编码，并生成主题以供进一步分析。
我们确定了有效ROP护理的关键障碍和促进因素。分析得出四个主要主题：（1）ROP的知识和认识，（2）实施ROP筛查计划的挑战和限制，（3）ROP筛查和治疗的培训与指南，以及（4）ROP预防筛查和管理的建议。ROP意识、对ROP与巫术的认识以及ROP被确定为ROP的知识和认识主题下的具体子主题。
本研究揭示了卫生工作者对ROP的知识和认识存在重大差距。基本设备和专业人员获取有限可能会进一步限制ROP筛查能力。我们建议采用多学科团队方法、持续专业发展并制定国家ROP指南。我们建议为ROP筛查制定正式的培训结构和教学大纲。该培训可增强在没有专业卫生工作者的地区卫生工作者之间的任务转移。解决已确定的障碍对于改善乌干达及类似环境中早产儿的护理和结局至关重要。
