Multiparameter Continuous Physiological Monitoring Technologies in Neonates Among Health Care Providers and Caregivers at a Private Tertiary Hospital in Nairobi, Kenya: Feasibility, Usability, and Acceptability Study
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Abstract
Background: Continuous physiological monitoring technologies are important for strengthening hospital care for neonates, particularly in resource-constrained settings, and understanding user perspectives is critical for informing medical technology design, development, and optimization. Objective: This study aims to assess the feasibility, usability, and acceptability of 2 noninvasive, multiparameter, continuous physiological monitoring technologies for use in neonates in an African health care setting. Methods: We assessed 2 investigational technologies from EarlySense and Sibel, compared with the reference Masimo Rad-97 technology through in-depth interviews and direct observations. A purposive sample of health care administrators, health care providers, and caregivers at Aga Khan University Hospital, a tertiary, private hospital in Nairobi, Kenya, were included. Data were analyzed using a thematic approach in NVivo 12 software. Results: Between July and August 2020, we interviewed 12 health care providers, 5 health care administrators, and 10 caregivers and observed the monitoring of 12 neonates. Staffing and maintenance of training in neonatal units are important feasibility considerations, and simple training requirements support the feasibility of the investigational technologies. Key usability characteristics included ease of use, wireless features, and reduced number of attachments connecting the neonate to the monitoring technology, which health care providers considered to increase the efficiency of care. The main factors supporting acceptability included caregiver-highlighted perceptions of neonate comfort and health care respondent technology familiarity. Concerns about the side effects of wireless connections, electromagnetic fields, and mistrust of unfamiliar technologies have emerged as possible acceptability barriers to investigational technologies. Conclusions: Overall, respondents considered the investigational technologies feasible, usable, and acceptable for the care of neonates at this health care facility. Our findings highlight the potential of different multiparameter continuous physiological monitoring technologies for use in different neonatal care settings. Simple and user-friendly technologies may help to bridge gaps in current care where there are many neonates; however, challenges in maintaining training and ensuring feasibility within resource-constrained health care settings warrant further research. International Registered Report Identifier (IRRID): RR2-10.1136/bmjopen-2019-035184
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Few studies have targeted the challenge of affordable continuous physiological monitoring for at-risk neonates in low-resource settings.
“Affordable, continuous physiological monitoring systems are a crucial tool for early deterioration detection and intervention of at-risk neonates, but few studies have targeted this challenge to improve the quality, access, and efficiency of care to reduce neonatal mortality in low-resource settings20,21.”
From Soft, all-in-one, nanomembrane wearable system for advancing neonatal health monitoring in Ethiopia (2025) · cites this paper as [21]
The Introduction says evidence on the feasibility, appropriateness, and acceptability of neonatal health technologies has not been adequately investigated. The Discussion identifies a literature gap concerning barriers to and enablers of these technologies in resource-constrained settings. Neither passage establishes that few studies have targeted affordable continuous monitoring specifically. (LLM, conf=0.78)
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Cites
Using thematic analysis in psychology
Braun, V., & Clarke, V. (2006) · Qualitative Research in Psychology · doi:10.1191/1478088706qp063oa · Cited by 194,414 · see citing works
Tong, A., Sainsbury, P., & Craig, J. (2007) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzm042 · Cited by 42,509 · see citing works
(1993) · Elsevier eBooks · doi:10.1016/c2009-0-21512-1 · Cited by 5,533 · see citing works
(2021) · doi:10.1056/nejmoa2026486 · Cited by 422 · see citing works
Wearable Sensor Systems for Infants
Zhu, Z., Liu, T., Li, G., Li, T., & INOUE, Y. (2015) · Sensors · doi:10.3390/s150203721 · Cited by 189 · see citing works
Missed nursing care in newborn units: A cross- sectional direct observational study \n
Gathara, D., Brownie, S. M., Murphy, G. A. V., Jackson, D., Serem, G., Obengo, A., Tallam-Kimaiyo, E., & English, M. (2019) · Wintec Research Archive (Waikato Institute of Technology) · Cited by 143 · see citing works
Assessment of neonatal care in clinical training facilities in Kenya
Aluvaala, J., Nyamai, R., Were, F., Wasunna, A., Kosgei, R. J., Karumbi, J., Gathara, D., & English, M. (2014) · Archives of Disease in Childhood · doi:10.1136/archdischild-2014-306423 · Cited by 88 · see citing works
Innovative approaches for improving maternal and newborn health - A landscape analysis
Lunze, K., Higgins‐Steele, A., Simen-Kapeu, A., Vesel, L., Kim, J. H., & Dickson, K. (2015) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-015-0784-9 · Cited by 85 · see citing works
Ginsburg, A. S., Agyemang, C. T., Ambler, G., Delarosa, J., Brunette, W., Levari, S., Larson, C., Sundt, M., Newton, S., Borriello, G., et al. (2016) · PLoS ONE · doi:10.1371/journal.pone.0165201 · Cited by 74 · see citing works
Self-citationMaynard, K. R., Causey, L., Kawaza, K., Dube, Q., Lufesi, N., Oden, Z. M., Richards-Kortum, R. R., & MOLYNEUX, E. M. (2015) · Paediatrics and International Child Health · doi:10.1179/2046905515y.0000000034 · Cited by 41 · see citing works
Wearable technology for infant health monitoring: a survey
Memon, S. F., Memon, M. A., & Bhatti, S. (2019) · IET Circuits Devices & Systems · doi:10.1049/iet-cds.2018.5447 · Cited by 31 · see citing works
Mugyenyi, G. R., Atukunda, E. C., Ngonzi, J. N. J., Boatin, A. A., Wylie, B. J., & Haberer, J. E. (2017) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-017-1361-1 · Cited by 27 · see citing works
Kinshella, M. W., Salimu, S. N., Chiwaya, B., Chikoti, F., Chirambo, L., Mwaungulu, E., Banda, M., Newberry, L., Njirammadzi, J., Hiwa, T., et al. (2020) · PLoS ONE · doi:10.1371/journal.pone.0243770 · Cited by 27 · see citing works
Self-citationCarns, J., Kawaza, K., Quinn, M. K., Miao, Y., Guerra, R., MOLYNEUX, E. M., Odén, M., & Richards-Kortum, R. R. (2018) · PLoS ONE · doi:10.1371/journal.pone.0194144 · Cited by 22 · see citing works
Mitchell, E. J., Qureshi, Z. P., Were, F., DANIELS, J. P., Gwako, G. N., Osoti, A. O., Opira, J., Bradshaw, L. E., Oliver, M., Pallotti, P., et al. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-039061 · Cited by 18 · see citing works
The child survival revolution: what next?
Lawn, J. E. (2014) · The Lancet · doi:10.1016/s0140-6736(14)61057-6 · Cited by 17 · see citing works
Ginsburg, A. S., Nkwopara, E., Macharia, W., Ochieng, R., Waiyego, M., Zhou, G., Karasik, R., Xu, S., & Ansermino, J. M. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-035184 · Cited by 16 · see citing works
Self-citationMissed nursing care in newborn units: a cross-sectional direct observational study
Gathara, D., Serem, G., Murphy, G. A. V., Obengo, A., Tallam, E., Jackson, D. W., Brownie, S. M., & English, M. (2019) · BMJ Quality & Safety · doi:10.1136/bmjqs-2019-009363 · Cited by 8 · see citing works
(2014) · African Studies Companion Online · doi:10.1163/_afco_asc_2248 · Cited by 1 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Grooby, E., Sitaula, C., Kwok, T. C., Sharkey, D., Marzbanrad, F., & Malhotra, A. K. (2023) · Pediatric Research · doi:10.1038/s41390-022-02416-x · Cited by 21 · see citing works
Wireless monitoring devices in hospitalized children: a scoping review
Sénéchal, E., Jeanne, E., Tao, L., Kearney, R. E., Shalish, W., & SantʼAnna, G. (2023) · European Journal of Pediatrics · doi:10.1007/s00431-023-04881-w · Cited by 15 · see citing works
Ginsburg, A. S., Nia, S. Z., Chomba, D., Dunsmuir, D. T., Waiyego, M., Coleman, J., Ochieng, R., Liu, S., Zhou, G., Ansermino, J. M., et al. (2022) · Scientific Reports · doi:10.1038/s41598-022-07189-1 · Cited by 6 · see citing works
Self-citationGinsburg, A. S., Nia, S. Z., Chomba, D., Parsimei, M., Dunsmuir, D. T., Waiyego, M., Coleman, J., Ochieng, R., Zhou, G., Macharia, W., et al. (2022) · Scientific Reports · doi:10.1038/s41598-022-16051-3 · Cited by 6 · see citing works
Self-citationEvaluation of a contactless neonatal physiological monitor in Nairobi, Kenya
Wang, D., Macharia, W., Ochieng, R., Chomba, D., Hadida, Y. S., Karasik, R., Dunsmuir, D. T., Coleman, J., Zhou, G., Ginsburg, A. S., et al. (2021) · Archives of Disease in Childhood · doi:10.1136/archdischild-2021-322344 · Cited by 5 · see citing works
Self-citationSénéchal, E., Radeschi, D. J., Kearney, R. E., Shalish, W., & SantʼAnna, G. (2025) · American Journal of Perinatology · doi:10.1055/a-2604-8329 · Cited by 2 · see citing works
Nantume, A., Oketch, B. A., Otiangala, D., Shah, S., Cauvel, T., Nyumbile, B., & Olayo, B. (2023) · Digital Health · doi:10.1177/20552076231182799 · Cited by 3 · see citing works
Soft, all-in-one, nanomembrane wearable system for advancing neonatal health monitoring in Ethiopia
Zhou, L., Joseph, M., Lee, Y. J., Yadav, D., Nayak, L., Woodall, J., Matthews, J., Soltis, I., Mekuria, F. M., Yeshanew, K. H., et al. (2025) · npj Digital Medicine · doi:10.1038/s41746-025-01974-8 · Cited by 3 · see citing works
“…continuous physiological monitoring systems are a crucial tool for early deterioration detection and intervention of at-risk neonates, but few studies have targeted this challenge to improve the quality, access, and ef fi ciency of care to reduce neonatal mortality in low-resource settings 20,21 .”
John-Akinola, Y. O., Ayede, A. I., Adeyemi, A. T., Nantume, A., Olaleye, A. O., Akinrinoye, O. O., Tongo, O. O., Alao, M. A., Oluleye, A., Sobande, O. J., et al. (2025) · Frontiers in Digital Health · doi:10.3389/fdgth.2025.1597651 · Cited by 1 · see citing works
A Wireless Neonatal Intensive Care Unit: Fiction or Closer Reality?
Sénéchal, E., Chung, H. U., Rogers, J. A., & SantʼAnna, G. (2025) · Neonatology · doi:10.1159/000547056 · Cited by 1 · see citing works
Sensors in Digital Health Solutions Empowered by Artificial Intelligence Capabilities
Hetemi, D., Pinson, J., Noël, V., Shkirskiy, V., & Hoti, K. (2026) · IEEE Sensors Reviews · doi:10.1109/sr.2026.3722596
- Authors
- Ginsburg, A. S., Kinshella, M.-L. W., Naanyu, V., Rigg, J., Chomba, D., Coleman, J., Hwang, B., Ochieng, R., Ansermino, J. M., & Macharia, W. M.
- Affiliations
- University of Washington (US)
- University of British Columbia (CA)
- Aga Khan University Nairobi (KE)
- BC Children's Hospital (CA)
- Corresponding author
- Kinshella, Mai-Lei Woo
- ORCID
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2021-10-28
- Volume
- 23
- Issue
- 10
- Pages
- e29755
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC8587184
- OpenAlex
- W3210002104
- Cited by
- 11
- References
- 18
- Citations by year
- 2026: 1 · 2025: 4 · 2023: 3 · 2022: 2 · 2021: 1
- FWCI
- 1.41
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- eCommons - AKU (Aga Khan University) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Bill and Melinda Gates Foundation (OPP12303136)
- Topics
- Health Sciences › Medicine › Surgery › Healthcare Technology and Patient Monitoring
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Keywords
- continuous physiological monitoring, neonatal care, multi-parameter monitoring, technical feasibility, usability, acceptability, healthcare workers, caregivers, wireless monitoring, electromagnetic fields, resource-limited settings, technology adoption
- MeSH terms
- Feasibility Studies, Health Personnel, Humans, Infant, Newborn, Kenya, Monitoring, Physiologic, Technology, Hospitals, Private, Caregivers, Tertiary Care Centers
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