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Parent and family perspectives on home-based newborn care practices in lower-income countries: a systematic review of qualitative studies
  1. Alessandra N Bazzano1,
  2. Erica Felker-Kantor1,
  3. Shalini Eragoda1,
  4. Aiko Kaji1,
  5. Raquel Horlick2
  1. 1 Global Community Health and Behavioral Sciences, Tulane University School of Public Health, New Orleans, Louisiana, USA
  2. 2 Howard Tilton Memorial Library, Tulane University, New Orleans, Louisiana, USA
  1. Correspondence to Dr Alessandra N Bazzano; abazzano{at}


Objectives To understand family and parent perspectives on newborn care provided at home to infants in the first 28 days of life, in order to inform behavioural interventions for improving care in low-income countries, where the majority of newborn deaths occur.

Design A comprehensive, qualitative systematic review was conducted. MEDLINE/PubMed, Embase and Cumulative Index of Nursing and Allied Health databases were systematically searched for studies examining the views of parents and family members on newborn care at home. The search period included all studies published from 2006 to 2017. Studies using qualitative approaches or mixed-methods studies with substantial use of qualitative techniques in both the methods and analysis sections were included. Studies meeting the inclusion criteria were extracted and evaluated using Critical Appraisal Skills Programme guidelines. Following the initial selection and appraisal, barriers and facilitators to recommended care practices across several domains were synthesised.

Results Of 411 results retrieved, 37 met both inclusion and quality appraisal criteria for methodology and reporting. Geographical representation largely reflected that of newborn health outcomes globally, with the majority of studies conducted in the region of Sub-Saharan Africa and South Asia. Specific barriers and facilitators were identified among a range of domains including: cord care, drying and wrapping, thermal control, skin to skin contact, hygiene, breast feeding, care-seeking for illness, and low birthweight recognition. Cross cutting facilitators, common to all domains were evident and included

delivery at a health facility, inclusion of female relatives in care counselling, lower healthcare costs, and exposure to newborn care behaviour change messaging in the community.

Conclusions When designing behavioural interventions to address newborn mortality at scale, policy-makers and practitioners must include barriers and facilitators important to families in low-income settings.

PROSPERO registration number CRD42016035674.

  • infant, newborn
  • postnatal care
  • qualitative research
  • care seeking
  • Cambodia

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  • Contributors Conception and design of the work: ANB, RH. Data collection: ANB, AK, EFK, RH. Data analysis and interpretation: ANB, AK, EFK. Drafting the article: ANB, AK, EFK, SE, RH. Critical revision of the article: ANB, AK, EFK, SE, RH. Final approval of the version to be published: ANB, AK, EFK, SE, RH.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data came from published articles available from electronic databases which are openly accessible.

  • Patient consent for publication Not required.