Women’s lived experiences of preterm birth and neonatal care for premature infants at a tertiary hospital in Ghana: A qualitative study

Abstract

Preterm birth is a leading cause of death in children under five and a major public concern in Ghana. Women’s lived experiences of care following preterm birth in clinical setting represents a viable adjunctive measure to improve the quality of care for premature infants. This qualitative study explored the knowledge and experiences of women who have had preterm birth and the associated challenges in caring for premature infants at a tertiary hospital. A qualitative design using in-depth interviews (IDIs) was conducted among women who experienced preterm birth with surviving infants at the Korle-Bu Teaching Hospital in Accra, Ghana. A thematic content analysis using the inductive analytic framework was undertaken using Nvivo. Thirty women participated in the study. We observed substantial variation in women’s knowledge on preterm birth: some women demonstrated significant understanding of preterm delivery including its causes such as hypertension in pregnancy, and potential complications including neonatal death whilst others had limited knowledge on the condition. Women reported significant social and financial challenges associated with preterm birth that negatively impacted the quality of postnatal care they received. Admission of preterm infants at the neonatal intensive care unit (NICU) generated enormous psychological and emotional stress on the preterm mothers due to uncertainty associated with the prognosis of their babies, health system challenges and increased cost. Context-specific recommendations to improve the quality of care for prematurely born infants were provided by the affected mothers and include urgent need to expand the National Health Insurance Scheme (NHIS) coverage and more antenatal health education on preterm birth. Mothers of premature infants experienced varied unanticipated challenges during the care for their babies within the hospital setting. While knowledge of preterm birth seems adequate among women, there was a significant gap in the women’s expectations of the challenges associated with the care of premature infants of which the majority experience psychosocial, economic and emotional impact.

A Phenomenological Study of the Lived Experiences of Mothers and Healthcare Professionals Caring for Preterm Babies in Abuja, Nigeria

“…Similar to the observations of Pinar and Erbaba [1] among Turkish mothers, some of these mothers cried because they felt that their babies had emaciated compared with what they saw at birth, coupled with their feelings of guilt and fear that they may be incapable of caring for their "fragile" newborns. At the same time, mothers had numerous unanswered questions about the baby's chances of survival, which is somewhat related to observations made by Adu-Bonsaffoh et al [13] among Ghanian mothers. These questions may not be unrelated to their knowledge of the odds of preterm survival, multiple complications, and the possibility of long-term sequalae after counseling sessions by pediatricians at admission of their babies to the NICU.…”

Challenges Faced by Healthcare Providers in Delivering High-Quality Care to Neonates in Ghana and West Africa

“…By tailoring protocols according to local realities, healthcare providers can bridge the gap between international best practices and local implementation, ensuring optimal care for neonates in Ghana and West Africa. From the comprehensive analysis of relevant selected studies in Ghana and West Africa [160][161][162][163] the specific challenges faced by healthcare providers in delivering high-quality care to neonates were revealed. Limited resources and infrastructure for neonatal care have been identified as a major obstacle, with inadequate facilities, equipment, and trained personnel hindering the provision of optimal care.…”

“…These cultural factors can sometimes conflict with evidence-based guidelines and protocols, further complicating the delivery of high-quality care. [170][171][172][173] Furthermore, there is a clear need for localized evidence-based guidelines for neonatal care that take into account the unique context of Ghana and West Africa. While international best practices provide valuable guidance, they must be tailored to address the specific challenges faced by healthcare providers in this region.…”

“…[174][175][176] These challenges are unique to the region and require tailored solutions that align with evidence-based guidelines and protocols. [177][178][179] This subsection of the research paper aims to compare and contrast the specific challenges faced by healthcare providers in Ghana, examine the evidence-based guidelines for neonatal care in West Africa, and explore how the local context of Ghana aligns with international best practices. One of the primary challenges faced by healthcare providers in Ghana is a lack of resources.…”

“…Limited funding, inadequate infrastructure, and a shortage of skilled personnel hinder the delivery of high-quality care to neonates. [180][181][182][183][184][185][186] Further, cultural beliefs and practices can affect healthcare-seeking behaviors, further complicating the provision of adequate neonatal care. [187][188][189] In contrast, evidence-based guidelines for neonatal care in West Africa provide a framework for improving health outcomes among neonates.…”