Facilitators and constraints to family integrated care in low‐resource settings informed the adaptation in Uganda

Author:

Kabajassi Olive1,Reiter Anna2,Tagoola Abner3,Kenya‐Mugisha Nathan1,O'Brien Karel4ORCID,Wiens Matthew O.15,Feeley Nancy67ORCID,Duby Jessica8ORCID

Affiliation:

1. Walimu Kampala Uganda

2. Faculty of Medicine McGill University Montreal Québec Canada

3. Jinja Regional Referral Hospital Jinja Uganda

4. Department of Paediatrics Sinai Health System Toronto Ontario Canada

5. Centre for International Child Health BC Children's & Women's Hospital Vancouver British Columbia Canada

6. Ingram School of Nursing McGill University Montreal Québec Canada

7. Centre for Nursing Research, Lady Davis Institute for Medical Research Jewish General Hospital Montreal Québec Canada

8. Department of Pediatrics McGill University Montreal Québec Canada

Abstract

AbstractAimFamily Integrated Care (FICare) was developed in high‐income countries and has not been tested in resource‐poor settings. We aimed to identify the facilitators and constraints that informed the adaptation of FICare to a neonatal hospital unit in Uganda.MethodsMaternal focus groups and healthcare provider interviews were conducted at Uganda's Jinja Regional Referral Hospital in 2020. Transcripts were analysed using inductive content analysis. An adaptation team developed Uganda FICare based on the identified facilitators and constraints.ResultsParticipants included 10 mothers (median age 28 years) and eight healthcare providers (seven female, median age 41 years). Reducing healthcare provider workload, improving neonatal outcomes and empowering mothers were identified as facilitators. Maternal stress, maternal difficulties in learning new skills and mistrust of mothers by healthcare providers were cited as constraints. Uganda FICare focused on task‐shifting important but neglected patient care tasks from healthcare providers to mothers. Healthcare providers learned how to respond to maternal concerns. Intervention material was adapted to prioritise images over text. Mothers familiar with FICare provided peer‐to‐peer support to other mothers.ConclusionUganda FICare shares the core values of FICare but was adapted to be feasible in low‐resource settings.

Funder

Faculty of Medicine, McGill University

Publisher

Wiley

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