Parental care provided to newborn infants in neonatal unit at hospital level- A qualitative study on parents’ experience and perspectives

Abstract

Introduction and objectives: The admission of a sick newborn is a stressful event for the parents. Preterm infants frequently require an extended period of admission prior to being medically fit for discharge. In resource-limited settings, such as Rwanda, nurse to neonate ratios are low and therefore, Family Integrated Care (FICare) is a necessity, integrating parents as primary caregivers of their sick newborns. This study aimed at identifying the care parents already deliver to their newborns in the neonatology unit, assessing if parents have a desire to deliver more care, and identifying challenges or barriers to FICare and EPCRs. Methods: A qualitative study was conducted involving in-depth interviews of 15 mothers who had newborns, born between 28 and 32 weeks gestation, and were admitted in the neonatal units of a District and Tertiary hospital in Kigali, Rwanda, from January 2018 to March 2018. Interviews were coded and a thematic analysis undertaken. Results: Parents reported meaningful package of care they were providing to their newborn infants like feeding newborns, doing activities related to cleanliness and hygiene, giving oral medications. Additionally, parents have expressed interest in providing supplementary care to their newborn, such as measuring weight and taking temperatures. There were many challenges, such as unstable mothers due to problems related to pregnancy or delivery, lack of knowledge and skills in neonatal care, financial limitations, and lack of family support. Parents highlighted the support they were expecting from healthcare providers (HCPs), especially the need of communication about health conditions of their neonates. They were also eager to learn more from HCPs regarding neonatal care. Conclusion: This study has shown that parents were actively involved in provision of care to their newborn babies and were eager to learn more about newborn care from healthcare providers. It has also revealed various social barriers faced by parents, limiting their participation to parental neonatal care. Thus, parental support and improved communication between parents and HCPs are recommended to overcome these barriers to FICare and EPCRs and to enhance participation of parents to the newborn care provision.