Factors affecting fathers' involvement in the care of preterm babies admitted in the Neonatal Unit at Kawempe National Referral Hospital

Abstract

Background: Fathers’ involvement in the care of preterm babies has been associated with good health outcomes for the mother and the baby. However, fathers’ involvement in the Neonatal Unit(NU) in Uganda remains sub-optimal and factors influencing this are not well understood. Objective: To explore the factors affecting fathers’ involvement in the care of preterm babies admitted in neonatal unit at Kawempe National Referral Hospital(KNRH).Methods; This was a qualitative exploratory study conducted in the NU at Kawempe National Referral Hospital between April and July 2023. It included fathers whose preterms babies were admitted in the NU and were stable (a baby whose vital signs were steady and not on ventilation) at the time of study. Data was collected using an in-depth interview guide with 24 fathers of preterm babies and key informant interview guide with the nine health workers who were working in the NU. Data was analyzed using manual thematic analysis. Results: The fathers in this study had a mean age of 33years, most of them were married and were employed in the informal sector. The perceived and actual roles of fathers of admitted preterms reported in this study mostly included providing financial support, direct childcare activities, providing emotional and physical support to the mother.The key facilitators to fathers’ involvement in the care of the preterms were; at individual level; improvement in health condition of the preterm baby, desire to fulfil responsibility, at interpersonal level, support from friends and relatives; at health facility level, the good quality of service delivery; and at community level, the positive cultural and religious beliefs. Barriers to fathers’ involvement in the care of preterms included the fear of preterm babies, financial constraints, busy working schedules of fathers, discouragements from peers and poor relationship between couples; poor attitude of some hospital staff, long hospital stay and inhibiting interaction between the father of preterm and mother-in-law. Conclusion: Most of the perceived roles were actually played by fathers in NU and mostly included provision of financial support, direct childcare activities and emotional support. Improvement in the health status of the preterms, support from friends and relatives, and good quality of service delivery facilitated the fathers’ involvement. However, fathers faced barriers like fear of preterms, financial constraints, busy working schedules, discouragement from peers and poor attitude of some hospital staff. Recommendations: Heath workers in KNRH should sensitize fathers on their roles and need for their involvement in the care of preterms in the NU. Hospital management should train hospital staff to ensure positive attitude as they interact with fathers and provide the drugs and other necessary supplies to reduce the economic burden on fathers.