ArticleBMJ paediatrics open2026
Barriers and drivers to implementing family integrated newborn care for preterm and low birthweight infants in neonatal care units in Ethiopia: a qualitative study.
Article in BMJ paediatrics open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe WHO recommends family involvement and support in the care of hospitalised preterm and low birthweight infants. However, little is known about the factors affecting uptake in resource-limited settings. This study aimed to understand the narratives of barriers and drivers of implementing Family Integrated Newborn Care (FINC) for preterm and low birthweight infants in neonatal care units (NCUs) in Ethiopia.
methodsA constructivist grounded theory was employed, involving face-to-face interviews with participants recruited from eight hospitals in Tigray, Northern Ethiopia. The study involved semistructured interviews with 21 purposively selected participants: 11 with healthcare providers (HCPs), four with key informant researchers and six with mothers of preterm or low birth weight infants. Data were inductively coded line-by-line, codes were translated into concepts, and concepts were transcended into abstract codes using Atlas.ti software.
resultsFive core categories emerged as narratives of barriers and drivers to FINC implementation in NCUs, including two barriers and three drivers. The barriers were mainly related to (1) perceived increased risk of infection and (2) ignorance regarding families' roles and rights. The drivers of FINC implementation included (1) reduced risk of infection, (2) mitigating safety concerns and (3) reduced workload. The narrative of a perceived heightened infection risk overshadowed the system-level infection risks, which misled healthcare establishments into adopting a restrictive visitation policy.
conclusionsDespite the potential role of families in preventing infection, mitigating safety concerns and reducing workload, a dominant narrative of perceived heightened infection risk resulted in a restrictive family visitation policy in NCUs. Linking the rights of families and neonates with the pragmatic clinical benefits of implementing FINC was recommended.
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