Family-centred care in the African Neonatal Network
Keywords:
Family-Centered Care; Patient-Centered Care; Neonatal Intensive Care Units; Infant, Newborn; Premature, Family; Counseling; Patient Satisfaction; Africa South of the Sahara; Global HealthAbstract
Abstract: Background: Family centred care (FCC) fosters collaboration between neonatal healthcare providers and families to improve outcomes. Despite global recognition, FCC implementation in African neonatal intensive care units remains inconsistent due to infrastructural, cultural, and policy-related challenges.
Methods: Fourteen hospitals in the African Neonatal Network responded to an annual facility survey and a health facility survey co -developed by faculty in the African Neonatal Network and Vermont Oxford Network. All analyses use descriptive statistics.
Results: Significant disparities exist in parental access: 29% of hospitals hinder access to mothers and 79% hinder access to fathers. Similarly, visitation policies restrict sibling (93%) and extended family (35%) access, potentially impacting parental stress and bonding. Despite these restrictions, 94% of hospitals expect families to provide daily infant care. Kangaroo Mother Care (KMC) is universally allowed (100%), yet activities such as bathing (52.9%), remain inconsistently permitted. Rooming-in facilities, essential for parental involvement, are available in only 41% of hospitals. Forty seven percent of hospitals provide private counselling spaces. While 71% of hospitals conduct patient satisfaction surveys, only 12% involve family representatives in hospital meetings and protocol developments. Cultural resistance to allowing fathers (29%) and other family members (12%) to participate in KMC further hinders full implementation.
Conclusions: This study underscores the urgent need for policy reforms, enhanced staff education on FCC, and improved infrastructure to facilitate inclusive FCC adoption. Addressing these challenges will help bridge the gap between evidence-based neonatal care and real-world implementation, ultimately improving neonatal outcomes and fostering stronger family engagement in care processes.
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