Father's involvement in the care of preterm newborn hospitalized in neonatal intensive care unit at selected hospital in Rwanda

Abstract

Background: Preterm birth remains a global health challenge with the highest burden in South Asia and sub-Saharan Africa where Rwanda is located. Despite the growing evidence that father involvement in neonatal intensive care units improves outcomes for preterm newborn such as enhanced bonding, feeding, psychomotor-development and reduced mortality, father involvement remains limited in many low-resource settings. Cultural norms, institutional barriers, lack of knowledge and emotional distress contribute to low father engagement. Addressing these challenges is essential for promoting family-centered neonatal care and improving survival and development of preterm newborns. Purpose: To explore factors influencing father's involvement in the care of preterm newborn hospitalized in neonatal intensive care unit at selected hospital in Rwanda. Methodology: A descriptive qualitative research design was used among fathers having preterm newborn hospitalized in neonatology at CHUK between February and March 2025. fathers whose preterms babies were admitted in the NICU who were stable were included. Data was collected using an in-depth interview guide on 18 fathers conveniently recruited and Data was analyzed using manual thematic analysis. Results: Through thematic analysis of interviews records on three key themes emerged preterm newborn-related, personal and environmental factors. This study identified factors influencing fathers’ involvement in preterm care such as fear of the status of the babies, emotional distress and cultural or socioeconomic barriers. The participants also stated that their involvement improved with support, education and inclusive healthcare practices. Findings highlight the need for fatherfriendly policies, flexible visitation, culturally sensitive education, and institutional support to enhance paternal engagement in neonatal care. Conclusion and Recommendations: The study effectively responded to research questions by exploring key barriers to fathers’ involvement in NICU care. However, findings imply a critical need for inclusive health system approaches that position fathers as active caregivers. Interventions such as father-focused education, communication and support groups are recommended to enhance engagement. Further research is needed to evaluate the impact of these interventions across diverse healthcare settings.