Feasibility and Usability of Low-Field Magnetic Resonance Imaging for Pediatric Neuroimaging in Low- and Middle-Income Countries: A Qualitative Study.

Background: The burden of neurological disorders in low- and middle-income countries (LMICs) may be underestimated due to the limited number of diagnostic imaging devices and trained specialists to operate and interpret scans. Recent advancements in low-field (<100 milliteslas) magnetic resonance imaging (LFMRI) hold significant promise for improving access to pediatric neuroimaging due to the technology's lower costs, portability, and reduced infrastructure and training requirements.

Purpose: Explore user needs and experiences on the training and use of a portable LFMRI for pediatric neuroimaging in LMICs.

Methods: We conducted qualitative interviews with end users of the LFMRI systems across 11 sites in Bangladesh, Ethiopia, Ghana, Malawi, Pakistan, South Africa, Uganda, and Zambia. A semi-structured questionnaire with open-ended questions on usability and feasibility was used to encourage participants to share their experiences and opinions on ease of use, user satisfaction, and integration into local health systems.

Results: Among 46 participants, key challenges were reported in infant positioning, power stability, and internet connectivity. Suggestions included developing reference materials with content and format tailored to local needs and contexts, conducting refresher trainings, and providing education that includes technical and maintenance support crucial for appropriate utilization and implementation sustainability.

Conclusion: This study underscores the importance of incorporating human-centered design principles and user feedback into identifying and resolving usability issues, sharing insights for successful integration of LFMRI within existing health care infrastructures in LMICs, and optimizing LFMRI use for pediatric populations.