Caregiver experiences and healthcare worker perspectives of accessing healthcare for low-birthweight

Abstract

Background: Low-birthweight (LBW) infants (<2500 g) are at greatest risk of mortality in the neonatal period, particularly in low-and middle-income countries. Timely access to quality healthcare averts adverse outcomes. Aim: To explore caregiver experiences and healthcare provider perspectives of accessing healthcare for LBW infants in rural Kenya. Methods: This qualitative study was undertaken in Homa Bay County� of rural western Kenya in June 2019. In-depth interviews� witheleven caregivers and four healthcare providers were conducted by a trained research assistant. All interviews were transcribed verbatim, and transcripts in the local languages were translated into English. A thematic framework was used to analyse the data. Results: At the community and individual level � ; community misconceptions about LBW infants, inadequate infant care practices after discharge, lack of maternal support networks, � long distances from healthcare facilities and lack of financial support� were key challenges. � In addition, long hospital waiting times, healthcare worker strikes and the apparent inadequate knowledge and skills of healthcare providers �were disincentives among caregivers. �Among � healthcare providers health system deficiencies, � (staff shortages and inadequate resources for optimal assessment and treatment of LBW infants � ) � and maternal illiteracy� were key challenges. � Education by staff during antenatal visits and community support groups �were enablers Conclusion: Accessing healthcare for LBW infants in this community � is fraught with challenge � s. � that has implications� for their post-discharge outcomes There is an urgent need to develop and test strategies� to address the barriers both at the at the community and health system level to� optimise outcome � s. �

Experiences of families and health professionals along the care continuum for low‐birth weight neonates: A constructivist grounded theory study

“…Smith et al (2012) argued that when families lack understanding of why their infants are hospitalized, they find it difficult comprehending the care processes thereby impairing their ability to recognize the severity of the infant's health status while possible warning signs might be overlooked later at home (Geerlings et al, 2019). Our study and others recommend that antenatal care visits should double as an avenue where families at risk of having LBW infants receive information on the implications of LBW deliveries and the possible need for a postnatal admission (Tekelab et al, 2019; Unsworth et al, 2021). In the absence of a neonatologist, a paediatrician, gynaecologist or a nurse‐midwife preferably with an advanced practice background could take over this task.…”

“…Mothers of LBW infants are often constrained by finances, work and the responsibility of caring for their vulnerable babies. Others have reported on inadequate maternal support and economic challenges faced by mothers post‐delivery (Sakyi et al, 2020; Unsworth et al, 2021). Similar to the needs and responsibilities our participants highlighted, in a recent Ghanaian study, women of preterm babies reported on practical (domestic chores/baby care), material, psychosocial and spiritual support (Tibil & Ganle, 2021).…”

Design and implementation of a community-based mother-to-mother peer support programme for the follow-up of low birthweight infants in rural western Kenya

“…A recent meta-analysis of postnatal care in sub-Saharan Africa showed that women living in rural areas with low literacy levels were less likely to utilise postnatal care services ( 37 ). This is likely to be worse among mothers of LBW infants, due to the stigma of having an LBW infant, which can result in a lack of prioritisation of the health needs of these infants within households ( 5 , 13 ). The regular contact with peer mothers enhanced the uptake of the recommended LBW infant feeding and care practices by intensifying the interventions and building resilience amongst the mothers.…”

“…A recent study in Kenya found that accessing healthcare for LBW infants in a rural community in western Kenya was fraught with challenges at the individual, community and health system levels ( 13 ). In Uganda, a study that explored the perceptions of carers of preterm infants post-discharge found that, although carers felt that they had acquired the knowledge and skills required to care for their newborns from the facility admission, in the community they struggled to maintain that quality of newborn care in the absence of ongoing support from healthcare providers ( 14 ).…”