Parental participation in the care of hospitalized neonates in low- and middle-income countries: A systematic review and meta-analysis

Anna Reiter; Julie De Meulemeester; Nathan Kenya-Mugisha; Abner Tagoola; Olive Kabajaasi; Matthew O Wiens; Jessica Duby

doi:10.3389/fped.2022.987228

Parental participation in the care of hospitalized neonates in low- and middle-income countries: A systematic review and meta-analysis

Front Pediatr. 2022 Aug 25:10:987228. doi: 10.3389/fped.2022.987228. eCollection 2022.

Authors

Anna Reiter¹, Julie De Meulemeester¹, Nathan Kenya-Mugisha², Abner Tagoola³, Olive Kabajaasi², Matthew O Wiens^{2

4

5}, Jessica Duby⁶

Affiliations

¹ Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
² Walimu, Kampala, Uganda.
³ Jinja Regional Referral Hospital, Jinja, Uganda.
⁴ Center for International Child Health, BC Children's Hospital, Vancouver, BC, Canada.
⁵ Department of Anesthesiology, Pharmacology & Therapeutics, Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC, Canada.
⁶ Department of Pediatrics, McGill University, Montreal, QC, Canada.

Abstract

Introduction: To determine the effect of parental participation in hospital care on neonatal and parental outcomes in low- and middle-income countries (LMICs) and to identify the range of parental duties in the care of hospitalized neonates in LMICs.

Methods: We searched CINAHL, CENTRAL, LILACs, MEDLINE, EMBASE and Web of Science from inception to February 2022. Randomized and non-randomized studies from LMICs were eligible if parents performed one or more roles traditionally undertaken by healthcare staff. The primary outcome was hospital length-of-stay. Secondary outcomes included mortality, readmission, breastfeeding, growth, development and parental well-being. Data was extracted in duplicate by two independent reviewers using a piloted extraction form.

Results: Eighteen studies (eight randomized and ten non-randomized) were included from seven middle-income countries. The types of parental participation included hygiene and infection prevention, feeding, monitoring and documentation, respiratory care, developmental care, medication administration and decision making. Meta-analyses showed that parental participation was not associated with hospital length-of-stay (MD -2.35, 95% CI -6.78-2.07). However, parental involvement was associated with decreased mortality (OR 0.46, 95% CI 0.22-0.95), increased breastfeeding (OR 2.97 95% CI 1.65-5.35) and decreased hospital readmission (OR 0.36, 95% CI 0.16-0.81). Narrative synthesis demonstrated additional benefits for growth, short-term neurodevelopment and parental well-being. Ten of the eighteen studies had a high risk of bias.

Conclusion: Parental participation in neonatal hospital care is associated with improvement in several key neonatal outcomes in middle-income countries. The lack of data from low-income countries suggests that there remains barriers to parental participation in resource-poor settings.

Systematic review registration: [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=187562], identifier [CRD42020187562].

Keywords: family nursing; infant; nursing; parents; patient-centered care.

Publication types

Systematic Review