Improving Preterm and Low Birth Weight Care Practices in Lubumbashi, Democratic Republic of Congo, Using a Family-Centered Model: A Qualitative Study

Abstract

IntroductionNeonatal mortality remains high in the Democratic Republic of Congo (28 per 1000 live births) and preterm birth complications is still the leading cause of all newborn deaths. Lubumbashi, the capital city of the Haut-Katanga province, is among the cities much affected by this issue. Between 2011 and 2018, 63% of all newborn deaths in the region were attributed to complications related to low birth weight. To address the issue, innovative healthcare interventions are needed. Numerous studies have shown that the family-centered care (FCC) approach has a positive impact not only on the infant but on parents and on the health facility as well. The aim of this research study is to assess health facilities readiness to implement this model of newborn care in Lubumbashi. Methods The study used qualitative data collection and analysis techniques to assess healthcare providers’ perceptions of and experiences with key components of the FCC model in maternity wards and neonatal intensive care units in the city of Lubumbashi, and to assess current care standard to identify factors that may affect parents and healthcare providers’ adherence to elements of the FCC model of care. Nineteen interviews were conducted with healthcare providers in ten health facilities across nine Health Zones in the city during August and September 2022. All the interviews were conducted in French. The records were transcribed and translated in English and later analyzed using Atlas.ti (23.1.1). Results Data analysis revealed that healthcare providers’ expectation of families’ participation in their newborn care are currently restricted to thermal protection (i.e. prolonged skin-to-skin contact) and breastfeeding. Findings also revealed potential enablers and challenges to the successful implementation of a FCC model. These enablers/challenges include hospital infrastructure and environment, newborn care practices, parents’ empowerment, health workers’ attitudes, families’ economic challenges, families’ religious/cultural beliefs, parents’ mental health challenges, and fathers’ irregular presence at health facilities. Conclusions Findings showed that families’ participation in preterm/Low Birth Weight infants’ care in Lubumbashi is minimal. The study also helped identify challenges related to newborn care that might affect the successful implementation of a FCC model in this region. Both families and medical facilities would greatly benefit from this care approach and thus maximize the chances of survival of preterm and low birth weight infants. But for this model of care to be effective, it must be adjusted to the situation and the evidence obtained on the ground.