Author:
Lyne Holly,Burgoine Kathy,Ogara Collin,Ditai James,Gladstone Melissa
Abstract
Abstract
Background
Complications of prematurity are the leading cause of neonatal mortality, and the majority of these deaths occur in low and middle-income countries. Research in these settings has focused on improved outcomes for preterm infants in hospital settings, however, research into the continuation of preterm care in the home after discharge from a neonatal unit is limited. This study examines the experiences and perceptions of caregivers of preterm infants during the initial weeks following discharge from a neonatal unit in Uganda, and the views of healthcare workers (HCWs) on the ability of caregivers to cope.
Methods
This qualitative study used multiple data collection approaches, namely focus group discussions (FGDs), in-depth interviews (IDIs), field observations, and case studies to explore the perceptions and experiences of providing care to preterm infants post-discharge from a neonatal unit in eastern Uganda from the perspectives of caregivers and HCWs.
Results
We recruited 39 participants with a total of 35 separate sessions including 18 IDIs (12 caregivers and 6 HCWs), 3 FGDs (17 caregivers), and 4 case studies (14 separate IDIs over 5 weeks after discharge, three mothers, and one grandmother). IDIs and FGDs took place at the Mbale Regional Referral Hospital or in participants’ homes.
Key themes emerged; preparation for continuing care in the home, psychosocial challenges to providing preterm care in the home, barriers to continuing preterm care in the home, and suggestions for improvement of preterm care in the home. Caregivers had good knowledge and awareness about different aspects of preterm care. Following discharge, caregivers struggled to maintain quality care due to loss of continuous support from the neonatal team, feelings of anxiety and isolation, financial issues, and home responsibilities.
Conclusion
This study highlights multiple challenges to continuing preterm care in this Ugandan setting. Improved training and education for caregivers, especially in neonatal resuscitation, enhanced and continued support of the caregiver and infant in the home, and increased community involvement following discharge may all be key solutions. These findings are fundamental to improving care in the home for preterm infants in eastern Uganda and similar settings.
Publisher
Springer Science and Business Media LLC
Reference66 articles.
1. Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH, et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ. 2010;88(1):31–8.
2. Conclusions from the WHO multicenter study of serious infections in young infants. The WHO Young Infants Study Group. Pediatr Infect Dis J. 1999;18(10 Suppl):32-4.
3. Okello F, Egiru E, Ikiror J, Acom L, Loe K, Olupot-Olupot P, et al. Reducing preterm mortality in eastern Uganda: the impact of introducing low-cost bubble CPAP on neonates < 1500 g. BMC Pediatr. 2019;19(1):311.
4. Waiswa P, Nyanzi S, Namusoko-Kalungi S, Peterson S, Tomson G, Pariyo GW. ‘I never thought that this baby would survive; I thought that it would die any time’: perceptions and care for preterm babies in eastern Uganda. Trop Med Int Health. 2010;15(10):1140–7.
5. World Health Organization MoD. The partnership for maternal, newborn & child health, save the Children. Born too soon: the global action report on preterm birth. 2012.
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