Mothers' perceptions and experiences of caring for sick newborns in Newborn Care Units in public hospitals in Eastern Uganda: a qualitative study.

INTRODUCTION: Mothers' participation in the care of their sick newborns in Newborn Care Units (NCUs) has been linked to several advantages including earlier discharge, fewer complications, better mother-baby bonding, and an easier transition to home after discharge. This study aimed to understand mothers' perceptions and experiences while participating in the care of their sick newborns in the NCUs to inform interventions promoting mothers' participation in public health facilities in Uganda. METHODS: We conducted an exploratory qualitative study comprised of 18 in-depth interviews with mothers caring for their newborns in two NCUs at a Regional Referral and General hospital in Eastern Uganda between April and May 2022. The interviews were audio-recorded and then transcribed. For analysis, we used a thematic analysis approach. RESULTS: The fear of losing their baby was an overarching theme that underlay mothers' perceptions, actions, and experiences in the NCU. Mothers' confidence in the care provided to their babies was based on their baby's outcomes. For example, when mothers saw almost immediate improvement after treatment, they felt more confident in the care than when this was not the case. Furthermore, mothers considered it essential that health care providers responded quickly in an emergency. Moreover, they expressed concerns about a lack of control over their personal space in the crowded NCU. Additionally, caring for babies in these settings is physically and financially taxing, with mothers requiring the combined efforts of family members to help them cope. CONCLUSION: This study shows that for mothers of sick newborns in the NCU, the baby's survival is the first concern and the basis of mothers' confidence in the quality of care provided. Efforts to improve parental participation in NCUs must focus on lowering the costs incurred by families in caring for a baby in the NCU, addressing privacy and space concerns, leveraging the family's role, and avoiding compromising the quality of care in the process of participation.

An assessment of admission pattern and treatment outcomes of neonates admitted in centers under facility-based newborn care program in Maharashtra, India.

Background: Newborn period is the most vulnerable period of life. As the rate of decline in neonatal mortality was slow compared to infant mortality rate, improved neonatal health-care services were started in existing facilities under facility-based newborn care program. Materials and Methods: A total of six special newborn care units at the district hospitals and 12 newborn stabilization units at the subdistrict/rural hospitals were included in the study. The outcome parameters were analyzed in the admitted babies using statistical tests. RESULTS: The mortality pattern was higher among low-birth-weight and preterm babies. The lower health-care centers had less neonatal deaths, as the neonates were referred. The common causes of admission were neonatal jaundice, respiratory distress syndrome, birth asphyxia, and so on. Conclusion: The focus on the high-risk babies needs to be strengthened, as these babies are at a high risk for neonatal mortality.

A Step toward Healthy Newborn: An Assessment of 2 Years' Admission Pattern and Treatment Outcomes of Neonates Admitted in Special Newborn Care Units of Gujarat.

CONTEXT: Facility Based Newborn Care (FBNC) is a key strategy to improve child survival, especially in newborn care where neonatal mortality rate (NMR) is stagnant in declining. Gujarat has achieved considerable amount of reduction in child deaths, but neonatal health requires attention. The study was aimed to assess the admission pattern of Special Newborn Care Units (SNCUs) which supports decision-making. SETTINGS AND DESIGN: A cross-sectional descriptive analysis was done from secondary data of the SNCU reports on the aspects of admission patterns, morbidity, and mortality pattern. The reports had been analyzed on various critical variables. RESULTS: In 2015-2016, Gujarat has operationalized forty SNCUs by saturating each district with at least one SNCU. The study found near proportions of (53%) inborn - (47%) outborn admission and 44% admission of female. Out of 69,662 admissions, 67% were discharged, 16% died, 10% leaving against medical advice, and 7% referred to higher centers. Major reasons for admission were respiratory distress syndrome (RDS) (22%) and infection (21%). Similar pattern in mortality found as final diagnosis of deaths was RDS (23%) and infection (21%). The proportion of neonatal deaths in outborn was high compared to inborn. CONCLUSION: Strengthening of FBNC is essential to address neonatal mortality. NMR is of prime focus because the health interventions needed to tackle NMR differ from those needed for infant mortality rate and under-five mortality rate. This accentuates the need for focused attention on facility- and community-based child health interventions along with quality maternal health services and robust referral mechanisms to all delivery points.