Experiences and perspectives of parents on their care roles in two Rwandan public neonatal units: a qualitative study.

Introduction: family integrated care (FICare) is increasingly regarded as best practice in neonatal units. However, little is known about how parents experience and perceive their care roles in neonatal units in low-resource settings such as Rwanda. This study explored lived experiences, attitudes, and perceptions of caregivers regarding parental care roles in two neonatal units in Rwanda. Methods: a qualitative study using semi-structured face-to-face interviews was conducted in one tertiary and one secondary neonatal unit in Kigali, Rwanda. A pragmatic content analysis approach was applied without a guiding theoretical framework. Results: sixteen caregivers (14 mothers, 1 father, 1 aunt) were interviewed; their infants had a mean gestational age of 29.5 weeks (SD±1.45). Seven themes emerged: experiences in the neonatal unit, current caregiver roles, readiness to provide care, attitudes towards extended roles, perceived benefits, barriers, and support needs. Parents reported emotional distress related to their infants´ illnesses and the hospital setting. They were already engaged in tasks such as feeding, hygiene, and bonding. Most expressed willingness to take on more responsibilities if supported through education and guidance. Reported barriers included limited skills, maternal illness, financial constraints, and restricted access to infants due to hospital policies and infrastructure. Conclusion: parents in two Rwandan neonatal units expressed a strong desire to participate more actively in their newborns' care. Efforts to expand their care roles should be encouraged and supported, where possible and safe, through structured education, accessible infrastructure, and emotional and material support from healthcare professionals.