Parent and family perspectives on home-based newborn care practices in lower-income countries: a systematic review of qualitative studies

Abstract

ObjectivesTo understand family and parent perspectives on newborn care provided at home to infants in the first 28 days of life, in order to inform behavioural interventions for improving care in low-income countries, where the majority of newborn deaths occur.DesignA comprehensive, qualitative systematic review was conducted. MEDLINE/PubMed, Embase and Cumulative Index of Nursing and Allied Health databases were systematically searched for studies examining the views of parents and family members on newborn care at home. The search period included all studies published from 2006 to 2017. Studies using qualitative approaches or mixed-methods studies with substantial use of qualitative techniques in both the methods and analysis sections were included. Studies meeting the inclusion criteria were extracted and evaluated using Critical Appraisal Skills Programme guidelines. Following the initial selection and appraisal, barriers and facilitators to recommended care practices across several domains were synthesised.ResultsOf 411 results retrieved, 37 met both inclusion and quality appraisal criteria for methodology and reporting. Geographical representation largely reflected that of newborn health outcomes globally, with the majority of studies conducted in the region of Sub-Saharan Africa and South Asia. Specific barriers and facilitators were identified among a range of domains including: cord care, drying and wrapping, thermal control, skin to skin contact, hygiene, breast feeding, care-seeking for illness, and low birthweight recognition. Cross cutting facilitators, common to all domains were evident and includeddelivery at a health facility, inclusion of female relatives in care counselling, lower healthcare costs, and exposure to newborn care behaviour change messaging in the community.ConclusionsWhen designing behavioural interventions to address newborn mortality at scale, policy-makers and practitioners must include barriers and facilitators important to families in low-income settings.PROSPERO registration numberCRD42016035674.

Low knowledge of newborn danger signs among pregnant women in Papua New Guinea and implications for health seeking behaviour in early infancy – findings from a longitudinal study

“…At childbirth, only one woman knew all four key danger signs that help identify life–threatening illness [ 3 ] and 17% could not report any danger signs. This is consistent with findings of studies in other resource–constrained settings such as India, Nigeria, Ethiopia, and Uganda [ 24 – 29 ] which identified inadequate maternal knowledge regarding newborn danger signs.…”

Hidden Realities of Infant Feeding: Systematic Review of Qualitative Findings from Parents

“…Completeness of reporting and potential of bias were addressed within the tool, as well as appropriateness of study design, methods, data collection, and analysis methods used. Since CASP does not use assessment scores, we adopted a 3-point rating system similar to others [16,17,19,26,30,31]. For each checklist item, studies were scored with 2 points if a CASP criterion was met, 1 point if unable to determine, and 0 points if the standard was not met.…”

Characteristics of Early Newborn Care: A Descriptive Analysis of Recent Births in Nigeria

“…Equally, these practices are highly influenced by cultural practices of parents or caregivers at home 10 and location of birth, given that one-half of neonatal deaths occur at home. 11,12 The objective of this study is to examine early newborn care practices in Nigeria. We explored associations between delivery location and early newborn care.…”