Do neonatal intensive care unit (NICU) health workers know about retinopathy of prematurity (ROP)? A qualitative study at a Regional Referral Hospital in Uganda

Introduction 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...

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Main Authors: Henry Muwonge, Innocent Ayesiga, Primrose Magala, Tom Didimus Ediamu, Hana El Diwany, Ian LY Yeung, Alex Wasomoka, Phillip Musoke, Elias Musiime, Abraham Tumwesigye, Pius Atwau, Noreen Atwijukire, Iddi Ndyabawe, Anne Mpaire Musika, Himanshu I Patel, Aeesha NJ Malik, Ibrahim Bwaga, Sheba Gitta Nakacubo
Format: Article
Language:English
Published: BMJ Publishing Group 2025-08-01
Series:BMJ Paediatrics Open
Online Access:https://bmjpaedsopen.bmj.com/content/9/1/e003104.full
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author Henry Muwonge
Innocent Ayesiga
Primrose Magala
Tom Didimus Ediamu
Hana El Diwany
Ian LY Yeung
Alex Wasomoka
Phillip Musoke
Elias Musiime
Abraham Tumwesigye
Pius Atwau
Noreen Atwijukire
Iddi Ndyabawe
Anne Mpaire Musika
Himanshu I Patel
Aeesha NJ Malik
Ibrahim Bwaga
Sheba Gitta Nakacubo
author_facet Henry Muwonge
Innocent Ayesiga
Primrose Magala
Tom Didimus Ediamu
Hana El Diwany
Ian LY Yeung
Alex Wasomoka
Phillip Musoke
Elias Musiime
Abraham Tumwesigye
Pius Atwau
Noreen Atwijukire
Iddi Ndyabawe
Anne Mpaire Musika
Himanshu I Patel
Aeesha NJ Malik
Ibrahim Bwaga
Sheba Gitta Nakacubo
author_sort Henry Muwonge
collection DOAJ
description Introduction 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.Methods 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.Results 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.Discussion and conclusion 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.
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spelling doaj-art-aad18652bcc14eefa812284c45875f712025-08-20T05:25:19ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722025-08-019110.1136/bmjpo-2024-003104Do neonatal intensive care unit (NICU) health workers know about retinopathy of prematurity (ROP)? A qualitative study at a Regional Referral Hospital in UgandaHenry Muwonge0Innocent Ayesiga1Primrose Magala2Tom Didimus Ediamu3Hana El Diwany4Ian LY Yeung5Alex Wasomoka6Phillip Musoke7Elias Musiime8Abraham Tumwesigye9Pius Atwau10Noreen Atwijukire11Iddi Ndyabawe12Anne Mpaire Musika13Himanshu I Patel14Aeesha NJ Malik15Ibrahim Bwaga16Sheba Gitta Nakacubo177 Department of Research, Uganda UK Health Alliance, Kampala, Uganda1 Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda3 Department of Medical Retina, Moorfields Eye Hospital NHS Foundation Trust, London, UK5 Hoima Regional Referral Hospital, Hoima, Uganda3 Department of Medical Retina, Moorfields Eye Hospital NHS Foundation Trust, London, UK3 Department of Medical Retina, Moorfields Eye Hospital NHS Foundation Trust, London, UK6 Republic of Uganda Ministry of Health, Kampala, Uganda7 Department of Research, Uganda UK Health Alliance, Kampala, Uganda2 Research Department, Ubora Foundation Africa, Kampala, Uganda2 Research Department, Ubora Foundation Africa, Kampala, Uganda8 Center for Biomedical Engineering, Indian Institute of Technology, New Delhi, India2 Research Department, Ubora Foundation Africa, Kampala, Uganda2 Research Department, Ubora Foundation Africa, Kampala, Uganda10 Department of Ophthalmology, Makerere University, Kampala, Uganda11 Department of pediatric ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK12 International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK5 Hoima Regional Referral Hospital, Hoima, Uganda13 Department of Research, Global Health Partnerships (formerly Tropical Health and Education Trust), Kampala, UgandaIntroduction 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.Methods 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.Results 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.Discussion and conclusion 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.https://bmjpaedsopen.bmj.com/content/9/1/e003104.full
spellingShingle Henry Muwonge
Innocent Ayesiga
Primrose Magala
Tom Didimus Ediamu
Hana El Diwany
Ian LY Yeung
Alex Wasomoka
Phillip Musoke
Elias Musiime
Abraham Tumwesigye
Pius Atwau
Noreen Atwijukire
Iddi Ndyabawe
Anne Mpaire Musika
Himanshu I Patel
Aeesha NJ Malik
Ibrahim Bwaga
Sheba Gitta Nakacubo
Do neonatal intensive care unit (NICU) health workers know about retinopathy of prematurity (ROP)? A qualitative study at a Regional Referral Hospital in Uganda
BMJ Paediatrics Open
title Do neonatal intensive care unit (NICU) health workers know about retinopathy of prematurity (ROP)? A qualitative study at a Regional Referral Hospital in Uganda
title_full Do neonatal intensive care unit (NICU) health workers know about retinopathy of prematurity (ROP)? A qualitative study at a Regional Referral Hospital in Uganda
title_fullStr Do neonatal intensive care unit (NICU) health workers know about retinopathy of prematurity (ROP)? A qualitative study at a Regional Referral Hospital in Uganda
title_full_unstemmed Do neonatal intensive care unit (NICU) health workers know about retinopathy of prematurity (ROP)? A qualitative study at a Regional Referral Hospital in Uganda
title_short Do neonatal intensive care unit (NICU) health workers know about retinopathy of prematurity (ROP)? A qualitative study at a Regional Referral Hospital in Uganda
title_sort do neonatal intensive care unit nicu health workers know about retinopathy of prematurity rop a qualitative study at a regional referral hospital in uganda
url https://bmjpaedsopen.bmj.com/content/9/1/e003104.full
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