An integrative review of parent-partnerships within neonatal care facilities in low- and lower-middle-income countries

Abstract

Background: Neonatal deaths in low-income countries account for a disproportionate percentage of all-mortality rates of children under 5. Parental-participation in neonatal care has been proven to improve outcomes for key developmental factors that influence morbidity and mortality of infants. Objectives: This review aims to explore the current models of parent-partnership used in neonatal care facilities and identify factors that influence effective utilisation in low-resource nations. Methods: This Integrative Review was performed by searching the databases of CINAHL, Medline and Global Health. The search was conducted using key-terms relating to Neonatology, Kangaroo Mother Care and Parent-Partnerships. Papers published between 2011 and 2021, from lower- and lower-middle-income countries, were included. Results: The search identified 336 publications. Following screening and full-text review, 24 studies were identified that satisfied the inclusion criteria. Data were quality-appraised using the Mixed-Methods Appraisal Tool and extracted utilising the framework described by Whittemore and Knafl. The analysis produced nine key themes – KMC as the predominant model of parent-partnership; the positive impact parent-partnerships have upon infants; the positive impact for parents; positive impact for nursing staff; enabling and limiting factors that influence implementation; pre-existing social and cultural barriers; task-sharing between staff and family; and how education influences perceptions. Conclusions: Economic, social and cultural factors have been identified that strongly influence and inhibit the widespread use of parent-partnerships in neonatal care facilities. KMC is the predominant model of parent-partnership. A future or adapted form of healthcare in these facilities should include a structured approach of education, empowerment, enhanced male and community involvement that simultaneously accommodates to the psychosocial needs of the family unit.