Experiences of mothers in the context of a staffing intervention in select newborn units in Kenyan public hospitals.
Dorothy Oluoch, Nancy Odinga, Caroline Waithira and 10 others
PMID 41004882WHAT IT FOUND
Adding nurses and ward assistants did not change mothers' bedside roles or nurse-mother communication in Kenyan neonatal units.
Mothers still lacked clear support, faced hurried or rude instructions. Ward assistants improved ward cleanliness, orientation and practical help.
Key findings
01At baseline, mothers were centrally involved in bedside care, including feeding, cleaning, monitoring and diaper changes, with minimal support or information.
02Mothers often received brief or disrespectful communication, leaving them unsure about procedures and afraid to ask for help.
03After adding nurses and ward assistants, mothers' roles and nurse-mother communication did not notably change; ward assistants improved ward hygiene and practical support.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only four hospitals were studied, so the findings may not apply to other settings. Different mothers were interviewed and observed at each phase, so the study could not track how one mother's experience changed over time. The hospitals also received NEST360 training and technologies, so the effect of added staff cannot be separated from the wider programme. The study describes mothers' experiences and does not measure clinical outcomes for babies or mothers. Observations and informal conversations are subjective, although weekly debriefs were used to support rigour.
Declared interests
Funded by NIHR using UK International Development Funding, Wellcome Trust, and a core grant to the KEMRI-Wellcome Trust Research Programme; funders had no role. Mike English reported NIHR financial support and Wellcome Trust article publishing charges and travel; Dorothy Oluoch reported administrative support from the KEMRI-Wellcome Trust Research Programme Nairobi; other authors declared no known competing interests.
The easy way to misread this
Do not conclude that staffing newborn units does not help mothers. This qualitative study found no notable change in mothers' roles or nurse communication after the intervention, but it did find improved ward cleanliness and practical support from ward assistants. The hospitals also received training and technologies, and different mothers were interviewed at each phase, so the study cannot separate the effect of added staff from the wider programme or track one mother's experience over time.