Feeding practices in public hospitals’ neonatal intensive care units: An exploration into the ways in which COVID-19 affected the best practice in Gauteng

Abstract

Background: South Africa’s healthcare system has a multitude of pre-existing challenges prior to the onset of the coronavirus disease 2019 (COVID-19) pandemic, ranging from reduced number of staff, lack of resources and units being at overcapacity both in the adult and paediatric populations. The neonatal intensive care units (NICUs) require a team approach to ensure best practice with vulnerable infants, but little is known about how the onset of the COVID-19 pandemic and the resultant lockdown restrictions impacted the feeding practices within the NICU.Objectives: This study aimed to explore the impact that COVID-19 had on the feeding practices within the NICU settings in public hospitals in Gauteng.Methods: A qualitative design was employed with data collected in two NICUs in Gauteng. Data were collected in the form of observations and semi-structured interviews with healthcare workers (HCWs) in the NICU. Data were analysed using inductive thematic analysis.Results: Although the sample size of participants was limited, social distancing proved to be a challenge resulting in mothers and healthcare workers being given restricted access. This had effects on the ability to provide adequate feeding practices and resulted in anxiety for the mothers and mental health challenges for the HCWs when feeding these at-risk infants. A limitation of this study was the use of only two sites.Conclusion: COVID-19 amplified the existing challenges in the NICU. A multidisciplinary and family-centred approach to address feeding challenges is required to offset the challenges resulting from the pandemic and subsequent lockdown.

The impact of COVID-19 on speech–language and hearing professions in low- and middle-income countries: Challenges and opportunities explored

“…Additionally, Karrim et al ( 2022 ) raised challenges with criteria, strategies and technical skills required for the utilisation of telerehabilitation by speech–language therapists and audiologists. For example, challenges were highlighted on telerehabilitation in children with autism spectrum disorder; middle ear assessments (Sebothoma & Khoza-Shangase, 2022 ); therapy for speech, language and swallowing following stroke (Tar-Mahomed & Kater, 2022 ); early communication intervention (Achmat & Gerber, 2022 ); neonatal feeding in neonatal intensive care units (Coutts et al, 2022 ); and geriatric audiology service provision in old age homes (De Andrade & Landman, 2022 ).…”

“…This included (1) access to technological devices (e.g. computers, laptops, tablets and smartphones), with a lack of resources reported by Coutts et al ( 2022 ); (2) connectivity in the form of access to Internet with good bandwidth; (3) stable power supply; and (4) technology-associated costs, including data costs (Khatib & Hlayisi, 2022 ; Khoza-Shangase, 2022a , 2022b ; McAllister et al, 2022 ; Tar-Mahomed & Kater, 2022 ). In South Africa, a major challenge was maintaining a stable power supply with load-shedding, which is scheduled national electricity supply interruption.…”

“…Furthermore, these authors highlighted maximising opportunities for remote working practices, which require improved use of ICT for research processes. Such approaches will enhance the quality of research designs (Khoza-Shangase, 2022a ), including contextually relevant and responsive longitudinal as well as large-scale studies required in LMICs to address key needs for evidence-based practice (Coutts et al, 2022 ; Khan et al, 2022 ; Khatib & Hlayisi, 2022 ; Khoza-Shangase, 2022b ; Masuku et al, 2022 ). Solutions must include considerations of, development and/or implementation of relevant policies so that researchers and participants are not harmed, research is supported and sustained, researchers are protected as employees and their mental health is looked after by research managers and research institutes.…”

“…Clinical practice-related solution themes to COVID-19 that emerged from the articles in the Special Issue of SAJCD in 2022 were the following: (1) intensified research into contextually relevant and responsive solutions to guide best practice, (2) technologically intelligent clinical skills training, (3) the need to explore and/or formalise and regulate the use of task-shifting and PSFs during telepractice, (4) robust technical infrastructure to support telepractice, (5) use of hybrid rehabilitation models, (6) prioritisation of mental health services for both patients and their caregivers as well as health care workers and (7) the need for quality standards and best-practice models to be maintained (Coutts et al, 2022 ; De Andrade & Landman, 2022 ; Karrim et al, 2022 ; Khatib & Hlayisi, 2022 ; Khoza-Shangase, 2022a , 2022b ; Madahana et al, 2022a, 2022b; Naidoo et al, 2022 ; Tar-Mahomed & Kater, 2022 ).…”

“…19. Coutts, Neille and Louw (2022) Feeding practices in public hospitals' neonatal intensive care units: An exploration into the ways in which COVID-19 affected best practice in Gauteng…”