Sammendrag
Background Neonatal jaundice is a common condition that can lead to brain damage and disabilities when severe
cases go undetected. Low- and middle-income countries often lack accurate methods for detecting neonatal
jaundice and rely on visual assessment, resulting in a higher incidence of adverse consequences. Picterus Jaundice Pro
(Picterus JP), an easy-to-use and affordable smartphone-based screening device for the condition, has demonstrated
higher accuracy than visual assessment in Norwegian, Philippine and Mexican newborns. This study aimed to identify
the barriers and facilitators to implementing Picterus JP in public health services in low-income settings in Mexico by
exploring the current process of neonatal jaundice detection and stakeholders’ perspectives in that context.
Methods Qualitative data collection techniques, including one focus group, 15 semi-structured interviews and four
observations, were employed in urban and rural health facilities in Oaxaca, Mexico. The participants included medical
doctors, nurses and health administrators. The data were analysed by thematic analysis guided by the Consolidated
Framework for Implementation Research.
Results The analysis yielded four main themes: (I) the current state of neonatal care and NNJ detection, (II) the needs
and desires for enhancing NNJ detection, (III) the barriers and facilitators to implementing Picterus JP in the health
system and (IV) HCWs’ expectations of Picterus JP. The findings identify deficiencies in the current neonatal jaundice
detection process and the participants’ desire for a more accurate method. Picterus JP was perceived as easy to use,
useful and compatible with the work routine, but barriers to adoption were identified, including internet deficiencies
and costs.
Conclusions The introduction of Picterus JP as a supporting tool to screen for neonatal jaundice is promising but
contextual barriers in the setting must be addressed for successful implementation. There is also an opportunity to
optimise visual assessment to improve detection of neonatal jaundice.
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