Table 3.

Barriers during screening process

Type of barriers	Details
Hospital procedure	The standard hospital procedure for the length of postnatal stay is relatively short, and therefore, most of the newborns were screened before 24 hours.
	Pulse oximetry measurement has yet to be part of the pre-discharge standard care for healthy newborns, and therefore, several healthcare personnel (especially nurses and midwives) did not routinely conduct measurements despite the ongoing study.
	Among subjects with positive screening results, echocardiography examinations were not all immediately performed. This was mainly caused by the availability of echocardiographs only at the tertiary and general hospitals, while some subjects were inpatients at the other two hospitals.
Equipment	The lack of pulse oximetry devices in the common wards, with devices only available at the neonatal ICU.
	Tightly fixed sensors using Velcro or rubber fasteners were not widely available, despite being easier and faster to use compared to fingertip-type pulse oximetry.
	Adult probes were sometimes utilized due to the limited resources in the ward.
Healthcare personnel	Healthcare personnel were often occupied with other clinical duties causing them to forget to perform the screening.
Condition of the baby	Some newborns were constantly crying or moving, making measurement of SpO2 difficult to perform using pulse oximetry.