Peer-reviewed article
Voices from the neonatal unit: Mothers' and healthcare workers' perspectives on respectful and collaborative care for small and sick newborns in rural districts in KwaZulu-Natal, South Africa.
Sphindile Mapumulo, Mary Kinney, Lyn Haskins, Silondile Luthuli, Vaughn M John et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how mothers and healthcare workers experience care in neonatal units in rural South Africa, focusing on whether care is respectful and involves families as partners. Mothers reported frustration with poor communication and being excluded from decisions about their babies' care. Healthcare workers identified significant barriers including overcrowding, staff shortages, and lack of space for mothers to be involved. The research found that while respectful family-centred care is important, rural neonatal units struggle to provide it effectively.
Key points
- Effective communication emerged as a foundational factor shaping mothers' experiences of care
- Many mothers reported inadequate, unfriendly communication and exclusion from clinical decision-making
- Health workers described barriers including overcrowding, staff shortages, fatigue, and lack of space for mothers to participate
- Persistent gaps exist in implementing respectful, family-centred newborn care within rural neonatal units
- Solutions require investment in health worker communication training, improved facility infrastructure, and policy changes to promote shared decision-making
Limitations
This study documents perspectives and barriers in rural KwaZulu-Natal but does not test whether specific interventions improve communication or family involvement. The findings are descriptive rather than evaluative of what works.
Abstract
Neonatal care increasingly emphasizes improving the experience of care by engaging mothers as active partners alongside health workers providing clinical care for newborns. Guided by the World Health Organization's Standards for improving the quality of care for small and sick newborns, this study focuses on Standard 4, which promotes care that is respectful, responsive, and supportive of families' needs and preferences. We conducted a concurrent triangulation mixed-methods study among health workers and mothers of small and sick newborns admitted to neonatal units in two rural districts of KwaZulu-Natal, South Africa. Effective communication emerged as a foundational factor shaping mothers' experiences of care. Many mothers reported frustration due to inadequate, unfriendly communication and exclusion from clinical decision-making, resulting in limited collaboration and lack of informed consent. Health workers, in turn, described barriers to providing respectful, family-centred care, citing overcrowding, staff shortages, fatigue, and lack of space for mothers to participate. Findings reveal persistent gaps in the implementation of Standard 4 within rural neonatal units. Strengthening communication and integrating family-centered newborn care in rural settings requires investment in health workers' communication training, facility infrastructure that enables maternal presence, and policy adaptations that promote shared caregiving and decision-making.