“My baby is fine, no need for more clinic visits.” Facilitators and barriers for utilisation of follow-up services for children born preterm in low-resource setting: Parents' perceptions

Flaviah B. Namiiro*, Barbara Nolens, Joseph Rujumba, Sarah Kiguli, Anthony Batte, Thomas van den Akker

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Objectives: We sought to understand the facilitators and barriers impacting utilisation of follow-up services for children born preterm as perceived by parents in a low-resource setting. Methods: We conducted a qualitative study at Mulago Hospital, Uganda, with parents of children born preterm and aged 22–38 months at the time of the study. We collected data using five in-depth interviews and four focus group discussions. Data were analysed using thematic analysis informed by the social–ecological model. Results: Ten subthemes emerged that could be grouped into three main themes: (1) Individual: parents' knowledge, parenting skills, perception of follow-up and infant's condition; (2) Relationship: support for the mother and information sharing; (3) Institution: facility setup, cost of care, available personnel and distance from the facility. Parents of preterm infants perceived receiving timely information, better understanding of prematurity and its complications, support from spouses, availability of free services and encouragement from health workers as facilitators for utilisation of follow-up services. Limited male involvement, parents' negative perception of follow-up, stable condition of infant, health facility challenges especially congestion at the hospital, distance and care costs were key barriers. Conclusion: An interplay of facilitators and barriers at individual, interpersonal and health system levels encourage or deter parents from taking their preterm children for follow-up services. Improving utilisation of services will require educating parents on the importance of follow-up even when children are not sick, eliciting maternal support from spouses and peers and addressing health system gaps that make follow-up unattractive and costly.

Original languageEnglish
Pages (from-to)194-202
Number of pages9
JournalTropical Medicine and International Health
Volume28
Issue number3
Early online date28 Jan 2023
DOIs
Publication statusPublished - Mar 2023

Bibliographical note

Funding Information:
Support was provided by the Forgaty International Center of National Institutes of Health, U.S. Department of State's Office of Global AIDS Coordinator and Health Diplomacy (S/GAC), and President's Emergency Plan for AIDS Relief (PEPFAR) under Award Number 1R25TW011213. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2023 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Funding

We thank the Management of Mulago Hospital, Staff at the Preterm Clinic, Research Assistants: Rachael Namono, Jennifer Wabulya, Flora Fawling, Carol Akello and Florence Nakirijja and the participants for sharing their experiences. Support was provided by the Forgaty International Center of National Institutes of Health, U.S. Department of State's Office of Global AIDS Coordinator and Health Diplomacy (S/GAC), and President's Emergency Plan for AIDS Relief (PEPFAR) under Award Number 1R25TW011213. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

FundersFunder number
Carol Akello and Florence Nakirijja
Management of Mulago Hospital
U.S. Department of State's Office of Global AIDS Coordinator and Health Diplomacy
Fogarty International Center
U.S. President’s Emergency Plan for AIDS Relief1R25TW011213

    Keywords

    • barriers
    • facilitators
    • follow-up
    • preterm
    • qualitative study
    • Uganda

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