The Role of Competency-Based Equipment User Training in Enhancing Healthcare Providers Skills in Utilizing bCPAP Devices for Newborn Care in Dar es Salaam, Tanzania: A Qualitative Study

Introduction Bubble Continuous Positive Airway Pressure (bCPAP) is an effective intervention for managing respiratory distress syndrome among preterm newborns. However, its successful utilization depends on healthcare providers possessing adequate knowledge and practical skills. In Tanzania, competency-based equipment user training has been introduced to strengthen providers' capacity to use neonatal technologies, including bCPAP. Despite these efforts, there is limited qualitative evidence on how this training influences healthcare providers' competence and routine clinical practice. This study explored the role of competency-based equipment user training in enhancing healthcare providers' skills in utilizing bCPAP devices for newborn care in Dar es Salaam, Tanzania. Methods A phenomenological qualitative study was conducted in three regional referral hospitals implementing the NEST360 programme. Purposive sampling was used to recruit doctors and nurses who had completed competency-based equipment user training. Data were collected through in-depth interviews using a semi-structured interview guide and analysed using Braun and Clarke's thematic analysis approach. Findings Six major themes emerged. Participants described competency-based training as a great approach for improving practical skills, confidence, and clinical decision-making regarding patient selection, device operation, monitoring, and weaning. Participants also reported improved equipment maintenance practices, reduced preventable equipment damage, and stronger collaboration with biomedical engineering professional . The training promoted positive changes in provider behaviour, including greater autonomy, internal mentorship of newly recruited staff, and increased accountability for equipment management. Participants further perceived improvements in neonatal care through earlier initiation of bCPAP, fewer unnecessary referrals, and better management of preterm newborns within their facilities. Conclusion Competency-based equipment user training strengthened healthcare providers' competence and confidence in utilizing bCPAP for newborn care while improving equipment management and interdisciplinary collaboration. Integrating competency-based training into routine newborn care programmes may enhance the effective implementation and sustainability of life-saving neonatal technologies in resource-limited settings.