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.
References
Committee on hospital care and institute for patient- and family-centered care. Patientand family-centered care and the pediatrician's role. Pediatr.2012;129 (2): 394–404.
Hodgson CR, Mehra R, Franck LS. Child and family outcomes and experiences related to family-centered care interventions for hospitalized pediatric patients: a systematic review. Children (Basel). 2024;11(8):949.
Chen S, Shen H, Jin Q, Zhou L, Feng L. Family-centered care in the neonatal intensive care unit: a meta-analysis and systematic review of outcomes for preterm infants. Transl Pediatr. 2025;14(1).
Lv B, Gao XR, Sun J, Li TT, Liu ZY, Zhu LH, Latour JM. Family-centered care improves clinical outcomes of very-low birth- weight infants: a quasi experimental study. Front Pediatr.2019;7:138.
Hadian Shirazi Z, Sharif F, Rakhshan M, Pishva N, Jahanpour F. Lived experience of caregivers of family-centered care in the neonatal intensive care unit: "Evocation of Being at Home". Iran J Pediatr.2016;26(5):e3960.
Abukari AS, Schmollgruber S. Concepts of family-centered care at the neonatal and paediatric intensive care unit: A scoping review. J Pediatr Nurs. 2023;71:e1-e10.
Al-Motlaq MA, Shields L. Family-centered care as a western-centric model in developing countries: luxury versus necessity. Holist Nurs Pract. 2017;31(5):343-347.
Johnson JO. Implementation of family centered care for neonates admitted in a special care baby unit in Sierra Leone. Pediatric Health Med Ther. 2024 May 17;15:189-199.
Apedani DB, Koduah A, Druye AA, Ebu NI. Experiences of mothers with preterm babies on support services in Neonatal Intensive Care Units in Ghana. Int J Africa Nursing Sci. 2021;15:100366.
Lomotey AY, Bam V, Diji AK, Asante E, Asante HB, Osei J. Experiences of mothers with preterm babies at a Mother and Baby Unit of a tertiary hospital: A descriptive phenomenological study. Nursing Open. 2020;7(1):150-159.
Bellizzi S, Panu Napodano CM, Murgia P. Family centered care for newborns: a global perspective and review. J Trop Pediatr. 2024;70(5):fmae026.
Wanduru P, Hanson C, Kwesiga D, Kakooza-Mwesige A, Mölsted Alvesson H, Waiswa P. Parental participation in newborn care in the view of health care providers in Uganda: a qualitative study. Reprod Health. 2024 Oct 29;21(1):155.
Boyamian TMDL, Mandetta MA, Balieiro MMFG. Nurses' attitudes towards families in neonatal units. Rev Esc Enferm USP. 2021;55:e03684.
Kahsay ZH, Medhanyie AA, Mariam DH, Ersdal HL, Rettedal S. Feasibility of implementing family-integrated newborn care for hospitalised preterm and low birthweight infants in newborn care units of Ethiopia: a mixed-methods design. BMJ Open. 2025;15(1):e093377
Eshetu T, Fekadu E, Abdella A, et al. Towards person centred maternal and newborn care in Ethiopia: a mixed method study of satisfaction and experiences of care. BMC Pregnancy Childbirth. 2025;25(1):85.
IPFCC. Framework for family involvement in quality improvement. 2004.
IPFCC. Partnering with families to accelerate change and improvement: Readiness assessment. 2022.
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