Perceived Barriers to Implementing Family Centered Care in Neonatal Intensive Care Units of Public Hospitals in Addis Ababa, Ethiopia, 2025
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Date
2025-06-14
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Addis Ababa University
Abstract
Background: Family-centered care (FCC) in neonatal intensive care units (NICUs) promotes
parental involvement, decreased neonatal mortality, and increase neonatal outcomes. Despite
worldwide evidence encouraging FCC, sub-Saharan Africa, including Ethiopia, affecting high
neonatal mortality rates (32.6 /1,000 live births) due to inadequate FCC implementation. While
studies in high-income countries suggested successful FCC, barriers in low-resource settings like
Ethiopia remain unexplored.
Objectives: This study aimed to explore perceived barriers to FCC implementation in NICUs
across public hospitals in Addis Ababa, Ethiopia.
Methodology: A descriptive design was used across three public hospitals (SPHMMC, Abebech
Gobna, and St. Peters). Purposively recruited ten healthcare providers (nurses, doctors) and nine
parents. An In-depth interviews were conducted using semi-structured guides question, translated,
transcribed, and analyzed thematically via Open Code 4.03. Trustworthiness was confirmed
through credibility, dependability, and confirmability measures.
Results: Nineteen interviews were conducted, with 10 health care provider participants and 9 care
givers with mean age of 26 (± SD = 0.38). Two main themes were identified as facility-related
barriers (lack of space, communication gaps, insufficient medicine supply, no FCC training, strict
protocol) and family-related barriers (low health literacy, logistical barriers, and emotional
distress). Congestion and bad NICU architecture limited family presence, and communication gaps
and medicals were barriers to engagement.
Conclusion and recommendation: Applying FCC in NICUs requires multifaceted strategies like
redesigning NICU room, flexible visitation rule, updating staff, and family support programs.
Addressing gaps through government-NGO partnerships and prioritizing parental involvement can
increase neonatal outcomes and reduce mortality. Future research might need explore FCC
interventions in diverse Ethiopian healthcare settings to investigating equitable, family-center
care.
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Keywords
Family-Centred Care (FCC), Neonatal Intensive Care Unit (NICU), Ethiopia.