BMC Pregnancy and Childbirth · 6 authors, 4 centres
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This ethnographic study compared mothers' participation in caring for sick newborns in two Kenyan hospitals with very different resources. It found that in the understaffed government hospital, mothers were informally and immediately required to provide primary care with little support, while in the better-staffed faith-based hospital, nurses performed most initial care, leaving mothers feeling separated and less prepared.
This was an ethnographic study using observations, informal conversations, and formal interviews conducted over 627 hours in the neonatal units of one government and one faith-based hospital in Kenya. The study explored how contextual factors shape maternal participation in caring for sick newborns. Key findings revealed stark differences: in the resource-constrained government hospital, understaffing led to the immediate and informal delegation of both primary (e.g., breastfeeding, diaper changing) and some specialized care (e.g., NG tube feeding) to mothers, often without adequate training or supervision. In the faith-based hospital, nurses initially performed most care tasks, with mothers gradually introduced to simple tasks under supervision. In both settings, appropriate breastfeeding support was lacking, and mothers' physical and psychological needs were largely ignored. The implications highlight that interventions must address structural inequities, such as chronic understaffing, and focus on better equipping nurses to support mothers, promoting family-centered care that respects the mother-infant dyad.
