Abstract
Background:
There is a shortage of medical personnel in hospitals in low- and middle-income countries (LMICs). Parents in LMICs may be vital partners in the care of their hospitalized newborns.
Methods
We performed a systematic review of parental participation in neonatal hospital-based care in LMICs. CINAHL, CENTRAL, LILACs, MEDLINE and EMBASE were searched from inception to June 2020. After duplicate removal, 6136 articles were screened. Randomized and non-randomized studies were eligible if parents performed one or more roles traditionally done by healthcare staff (such as monitoring for signs of distress, diaper changing, or bottle feeding). The primary outcome was hospital length-of-stay. Study selection, data extraction, and bias assessment were performed by two independent reviewers.
Results:
15 studies (six randomized and nine non-randomized) were included from six middle-income countries. Trials were heterogeneous in terms of study design, type of family involvement and outcomes reported. There were mixed results associated with length of stay. Enhanced parental participation consistently increased breastfeeding rates (n=6/6) and predominantly improved weight gain (n=8/9), overall mortality (n=6/7), parental wellbeing (n=4/5), and readmission rates (n=3/4). The risk of bias ranged from moderate to critical for all studies.
Conclusion:
The available evidence is insufficient to recommend a specific type of family involvement in the care of hospitalized newborns in LMICs, as its overall quality is low. Furthermore, no studies were conducted in low-income countries.
