Implementation barriers and facilitators of Moyo foetal heart rate monitor during labour in public hospitals in Nepal

Globally, every year, approximately 1 million foetal deaths take place during the intrapartum period, fetal heart monitoring (FHRM) and timely intervention can reduce these deaths. This study evaluates the implementation barriers and facilitators of a device, Moyo for FHRM. The study adopted a quali...

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Bibliographic Details
Published in:	Global health action Vol. 17; no. 1; p. 2328894
Main Authors:	Kc, Ashish, Rönnbäck, Mikaela, Humgain, Urja, Basnet, Omkar, Bhattarai, Pratiksha, Axelin, Anna
Format:	Journal Article
Language:	English
Published:	United States Taylor & Francis 31-12-2024 Taylor & Francis Group
Subjects:	barriers for implementation facilitators for implementation Female Fetal fetal heart rate monitoring practice change Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi Heart Rate Heart Rate, Fetal - physiology Hospitals Hospitals, Public Humans Labor Labor, Obstetric Moyo Nepal Obstetric Parturition physiology Pregnancy Public Public Health, Global Health, Social Medicine and Epidemiology Qualitative Research Nepal Moyo fetal heart rate monitoring practice change facilitators for implementation barriers for implementation Nepal
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Summary:	Globally, every year, approximately 1 million foetal deaths take place during the intrapartum period, fetal heart monitoring (FHRM) and timely intervention can reduce these deaths. This study evaluates the implementation barriers and facilitators of a device, Moyo for FHRM. The study adopted a qualitative study design in four hospitals in Nepal where Moyo was implemented for HRM. The study participants were labour room nurses and convenience sampling was used to select them. A total of 20 interviews were done to reach the data saturation. The interview transcripts were translated to English, and qualitative content analysis using deductive approach was applied. Using the deductive approach, the data were organised into three categories i) changes in practice of FHRM, ii) barriers to implementing Moyo and iii) facilitators of implementing Moyo. Moyo improved adherence to intermittent FHRM as the device could handle higher caseloads compared to the previous devices. The implementation of Moyo was hindered by difficulty to organise training ondevice during non-working hours, technical issue of the device, nurse mistrust towards the device and previous experience of poor implementation to similar innovations. Facilitators for implementation included effective training on how to use Moyo, improvement in intrapartum foetal monitoring and improvement in staff morale, ease of using the device, Plan Do Study Act (PDSA) meetings to improve use of Moyo and supportive leadership. The change in FHRM practice suggests that the implementation of innovative solution such as Moyo was successful with adequate facilitation, supportive staff attitude and leadership.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Joint first authors.
ISSN:	1654-9716 1654-9880 1654-9880
DOI:	10.1080/16549716.2024.2328894