Implementation Barriers

Healthcare providers accounted for the largest share of identified barriers. Some hospital implementation criteria do not strictly align with WHO Early Essential Newborn Care guidelines. The review identified 467 implementation barriers across 27 themes. Insufficient clinical evidence inhibited prescription in some interventions, including biosimilars. Low adoption of skin-to-skin contact within 15 minutes after birth was found in a survey from Cambodia and the Lao People’s Democratic Republic. Task-sharing, peer facilitators, manuals, and co-therapist models helped address provider-level constraints. Clinical nursing research implementation was hindered by workload, long research processes, ethical dilemmas, power dynamics, limited physician recognition, and weak academic tradition. Lack of clear institutional guidelines and policies was reported as an organisational barrier in 14.1% of studies. The most consistent implementation barriers were commissioning and funding gaps, lack of national clinical guidelines, insufficient training, weak shared care and multidisciplinary structures, and resistance to change. Lack of time and lack of interest were main reasons organisations refu…