T A Mills1, E Ayebare2, R Mukhwana3, J Mweteise2, A Nabisere2, A Nendela3, P Ndungu4, M Okello5, G Omoni6, S Wakasiaka6, R Wood1, T Lavender1. 1. Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK. 2. Department of Nursing, College of Health Sciences, Makerere University, Kampala, Uganda. 3. Lugina Africa Midwives Research Network (LAMRN) Kenya, C/O University of Nairobi, Nairobi, Kenya. 4. NIHR Global Health Group Community Involvement and Engagement (CEI) Group Kenya, C/O LAMRN Kenya, University of Nairobi, Nairobi, Kenya. 5. NIHR Global Health Group Community Involvement and Engagement (CEI) Group Uganda, Bweyogerere, Wakiso, Uganda. 6. School of Nursing Sciences, University of Nairobi, Nairobi, Kenya.
Abstract
OBJECTIVE: To explore parents' lived experiences of care and support following stillbirth in urban and rural health facilities. DESIGN: Qualitative, interpretative, guided by Heideggerian phenomenology. SETTING: Nairobi and Western Kenya, Kampala and Central Uganda. SAMPLE: A purposive sample of 75 women and 59 men who had experienced the stillbirth of their baby (≤1 year previously) and received care in the included facilities. METHODS: In-depth interviews, analysed using Van Manen's reflexive approach. RESULTS: Three main themes were identified; parents described devastating impacts and profound responses to their baby's death. Interactions with health workers were a key influence, but poor communication, environmental barriers and unsupportive facility policies/practices meant that needs were often unmet. After discharge, women and partners sought support in communities to help them cope with the death of their baby but frequently encountered stigma engendering feelings of blame and increasing isolation. CONCLUSIONS: Parents in Kenya and Uganda were not always treated with compassion and lacked the care or support they needed after the death of their baby. Health workers in Kenya and Uganda, in common with other settings, have a key role in supporting bereaved parents. There is an urgent need for context and culturally appropriate interventions to improve communication, health system and community support for African parents. TWEETABLE ABSTRACT: Health-system response and community support for parents after stillbirth in Kenya and Uganda are inadequate.
OBJECTIVE: To explore parents' lived experiences of care and support following stillbirth in urban and rural health facilities. DESIGN: Qualitative, interpretative, guided by Heideggerian phenomenology. SETTING: Nairobi and Western Kenya, Kampala and Central Uganda. SAMPLE: A purposive sample of 75 women and 59 men who had experienced the stillbirth of their baby (≤1 year previously) and received care in the included facilities. METHODS: In-depth interviews, analysed using Van Manen's reflexive approach. RESULTS: Three main themes were identified; parents described devastating impacts and profound responses to their baby's death. Interactions with health workers were a key influence, but poor communication, environmental barriers and unsupportive facility policies/practices meant that needs were often unmet. After discharge, women and partners sought support in communities to help them cope with the death of their baby but frequently encountered stigma engendering feelings of blame and increasing isolation. CONCLUSIONS: Parents in Kenya and Uganda were not always treated with compassion and lacked the care or support they needed after the death of their baby. Health workers in Kenya and Uganda, in common with other settings, have a key role in supporting bereaved parents. There is an urgent need for context and culturally appropriate interventions to improve communication, health system and community support for African parents. TWEETABLE ABSTRACT: Health-system response and community support for parents after stillbirth in Kenya and Uganda are inadequate.
Authors: Anna Agnes Ojok Arach; Juliet Kiguli; Victoria Nankabirwa; Noeline Nakasujja; David Mukunya; Milton W Musaba; Agnes Napyo; James K Tumwine; Grace Ndeezi; Joseph Rujumba Journal: BMC Pregnancy Childbirth Date: 2022-06-15 Impact factor: 3.105
Authors: Elizabeth Ayebare; Grace Ndeezi; Anna Hjelmstedt; Jolly Nankunda; James K Tumwine; Claudia Hanson; Wibke Jonas Journal: Reprod Health Date: 2021-02-05 Impact factor: 3.223
Authors: R Milton; F I Alkali; F Modibbo; J Sanders; A S Mukaddas; A Kassim; F H Sa'ad; F M Tukur; B Pell; K Hood; P Ghazal; K C Iregbu Journal: BMC Pregnancy Childbirth Date: 2021-12-14 Impact factor: 3.007