Acceptability of a family-centered newborn care model among providers and receivers of care in a Public Health Setting: a qualitative study from India

Abstract

BackgroundFamily-centered care (FCC), based on collaborative participation of the family along with a team of health care providers, is found to increase the well-being of sick infants in neonatal critical care units. Over the last 4 years, the neonatal unit of Dr. Ram Manohar Lohia Hospital in Delhi has innovated and developed an implementation framework for FCC. This qualitative study assessed the acceptability of family-centered care among providers and family members of neonates to identify gaps and challenges in implementation.MethodsIn-depth interviews were conducted among a purposive sample of twelve family members of admitted neonates and six providers to examine their perceptions and experiences regarding FCC.ResultsFamily members and providers expressed a positive perception and acceptance of FCC based on the competencies and knowledge acquired by parents and other caregivers of essential newborn care. Family members reported being satisfied with the overall health care experience due to the transparency of care and allowing them to be by their baby’s bedside. Limitations in the infrastructure or lack of facilities at the public hospital did not seem to dilute these positive perceptions. Providers also perceived FCC as a good practice to be continued in spite of concerns around sharing of nursery space with parents, the need for constant vigilance of parents’ practices in handling of their newborns, and the need for separate, designated nursing staff for FCC.ConclusionBoth providers and receivers of neonatal care found FCC to be an acceptable form of care. Providers identified challenges and suggested possible solutions, such as need of periodic provider sensitization on FCC, improved staff organization, and provision of mother-friendly facilities to enable her to provide around-the-clock care by her baby’s bedside. Overcoming these challenges would allow for better integration of FCC within general clinical care in neonatal care units.Electronic supplementary materialThe online version of this article (10.1186/s12913-019-4017-1) contains supplementary material, which is available to authorized users.

Our son is ‘our asset, future, and bank’: exploring gender-related factors influencing adherence to advice and treatment-seeking guidance following hospital discharge among infants and young children in Bangladesh

“…Our ndings suggest that interventions should include a strong emphasis on communication training and support for all medical practitioners, to understand how gender affects their interactions with community members, and what might be done to overcome challenges encountered. Several male practitioners in our work suggested, supported by studies elsewhere [43], that strategies such as medical practitioners engaging fathers can be valuable in building relationships and trust. More in-depth gender analyses at health facility level are needed to inform locally appropriate gender awareness programs at hospital and primary health care levels.…”

“…These household/community level ndings, and their interaction with health system factors, suggest that health related interventions must engage men and promote gender equity. Men must come to be seen -and see themselves -as active agents of change in supporting their female partners (mother of the children) in raising their children, and in following post-discharge medical advice when they are acutely ill [43,52]. More fundamentally, our ndings support others [22,23] in demonstrating that the patriarchal norms that limit women's access to household resources and participation in making decisions for the health and well being of all acutely ill children, and especially girls, must be challenged.…”

Reasons for and Facilitating Factors of Medical Malpractice Complaints. What Can Be Done to Prevent Them?

“…This result was related to another result of our study indicating that the lack or deficiency of communication was a more common reason for complaint by the patient’s family (when the patient died, or the patient was a newborn or incompetent). Data from the literature indicate the need for a family-centered approach in the medical settings for the care of newborns, requiring the adequate approach of the parents [ 40 , 42 , 43 ]. In a family-centered approach, the parents and the doctor form a partnership in which the parents are offered the opportunity to actively participate in the care of their child [ 42 , 43 ].…”

Effect of Family-centered Care Interventions on Motor and Neurobehavior Development of Very Preterm Infants: A Protocol of Systematic Review

“…FCC's values include family care, inclusive family engagement, interaction, empathy for and integrity of families, and knowledge transformation [11]. It has been implemented in developed and a few of the developing countries [14]. FCC can be practiced in various settings such as homes, clinics, hospitals, and communities.…”