This report documents the introduction and evaluation of Vayu Bubble Continuous Positive Airway Pressure (bCPAP) devices across five healthcare facilities in Bangladesh through Save the Children’s SWAP project from 2022-2025. Given Bangladesh’s status as having the world’s highest preterm birth rate at 16.2%, the Vayu bCPAP technology addresses a critical need for managing respiratory distress in newborns—a leading cause of preterm-related deaths. The Vayu bCPAP device is designed as an electricity-free solution that provides non-invasive ventilation while allowing precise control of oxygen concentration, flow, and pressure to prevent complications like retinopathy of prematurity.
The implementation followed a cascade training approach, with 24 Vayu bCPAP devices distributed across the five SWAP facilities. Training was conducted virtually by the Vayu Foundation team, creating 20 master trainers who then trained 60 facilitators and 116 healthcare providers. The rollout varied across facilities based on their existing CPAP capabilities, patient populations, and service patterns. Notably, four facilities already had other CPAP devices, while Lakshmipur District Hospital had no prior CPAP experience, creating different contexts for implementation.
Over the project period, 1,399 newborns received treatment with Vayu bCPAP, with utilization patterns showing high initial uptake followed by more modest but sustained use. Evaluation data from October 2024-March 2025 revealed that 58% of babies treated were full-term, with roughly equal numbers of inborn and outborn patients. Among outborn babies, the largest proportion (34.7%) were born at home, highlighting the device’s role in serving vulnerable populations. The technology was primarily used in Special Care for Newborn Units (SCANUs) and Neonatal Intensive Care Units (NICUs), with Vayu devices exceeding usage of conventional bCPAP in these critical care areas.
Clinical outcomes demonstrated the device’s effectiveness, with 52% of newborns successfully weaned off Vayu bCPAP compared to 48% with conventional devices. Among patients with very severe respiratory distress (46% upon initiation), significant improvement was observed within eight hours, with only 12% remaining in the very severe category. However, implementation challenges included healthcare provider confidence issues, maintenance requirements, supply chain difficulties for consumables, and data collection inconsistencies. The report recommends strengthening local capacity, developing user-friendly maintenance guides, establishing local supply chains for consumables, and integrating Vayu-specific data systems into routine health information systems for successful nationwide scaling.
