Peer-reviewed article
Healthcare worker's views and experiences of factors impacting confidence to provide perinatal bereavement support: a qualitative study in Malawi and Zimbabwe.
Chilinda I, Goshomi U, Smith DM, Chimwaza A, Lavender T et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study explored the views and experiences of 66 healthcare workers in Malawi and Zimbabwe about providing bereavement support to parents after stillbirth or neonatal death. Healthcare workers identified two main barriers: personal feelings of inadequacy and insufficient education, and lack of organizational support and professional development at facility level. The findings suggest that improving training, mentorship, and management support could help healthcare workers provide better care to bereaved families after perinatal loss.
Key points
- Approximately 1.9 million stillbirths and 2.5 million neonatal deaths occur annually worldwide, with the majority in low- and middle-income countries
- Healthcare workers reported feeling inadequate and lacking sufficient education to provide bereavement support
- Facilities lacked organizational support, continuing professional development, and mentorship for staff
- Healthcare workers expressed feeling unsupported in their roles providing bereavement care
- Solutions identified include improved access to pre- and in-service education, training, mentorship, and management support
Limitations
This study captures healthcare workers' perspectives and experiences but does not measure the actual quality of bereavement support provided to bereaved parents, nor does it assess outcomes for families receiving such care. The findings are specific to four maternity facilities in Malawi and Zimbabwe and may not be generalizable to other settings.
Abstract
Background Worldwide, around 1.9 million babies are stillborn, and 2.5 million newborns die soon after birth annually, the overwhelming majority occur in low- and middle-income countries (LMICs). Perinatal death has devastating impacts for families and communities, but not all parents receive adequate respectful bereavement support. Healthcare workers in LMICs often report that bereavement support is challenging, but few studies have explored factors that impact their confidence to deliver optimal care. Objective To explore healthcare worker's views and experiences of factors impacting their confidence to provide bereavement support to parents after stillbirth or neonatal death in Malawi and Zimbabwe. Methods Using qualitative approaches, a purposive sample of healthcare workers in four maternity facilities in Malawi and Zimbabwe was recruited. Guided by the principles of information power, six dual-moderated focus groups supplemented with eight individual in-depth interviews were conducted. The focus group discussions and interviews were audio-recorded and transcribed verbatim. Data were analyzed using the framework method. Results Sixty-six healthcare workers, including midwives, nurses, service managers, nurse educators, and doctors, participated. Two main themes were identified: (1) 'at least we tried our best' reflecting individual factors including feelings of inadequacy and insufficient education, and (2) 'as a facility we are not quite there yet' characterized by a lack of organizational support, feeling unsupported and a lack of continuing professional development. Conclusion Findings highlight the need to address the individual and environmental barriers to providing support to bereaved women and families. Improving access to pre- and in-service education and training, mentorship and management support are potential solutions.