Behavior Profile: Nurturing Care| Goal has not been set | ||
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Provider delivers nurturing, respectful care throughout the continuum of antenatal care, delivery, and post-natal care |
Behavior Analysis |
Strategy | ||
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BEHAVIOR AND STEPSWhat steps are needed to practice this behavior?Provider delivers nurturing, respectful care throughout the continuum of antenatal care, delivery, and post-natal care
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FACTORSWhat factors may prevent or support practice of this behavior?StructuralAccessibility: A discharged mother might live far from the facility where her baby remains an in-patient, making regular engagement very difficult Service Provider Competencies: Lack of clear policies and guidelines on these aspects of care, and policies that exist are still in development or not widely shared Service Provider Competencies: Provider Capacity and Commitment: Lack of training on newborn neurodevelopmental concerns: providers are well-trained on pathology and physiology, but not on psychological aspects Service Provider Competencies: Provider Capacity and Commitment: Providers feel engaging parents in care is a risk to efficient or effective care, rather than a benefit in them Service Provider Competencies: Provider Capacity and Commitment: Lack of understanding of the importance of creating a quiet, low-light, or other soothing environment Service Provider Competencies: Provider Capacity and Commitment: Capacity of parents to engage in care varies widely, making systematic engagement timely and complicated Service Experience: Existing policies and guidelines often limit parental involvement in delivery and inpatient special newborn care Service Experience: Parental role in newborn care, even including consent for care, is not discussed during ANC, making engagement at birth complicated Service Experience: Clients often have limited medical literacy and do not feel equipped to request anything different from the status quo; often, they are also disempowered or not informed about the important role a healing environment can play in their child’s life Service Experience: Facilities do not have physical space and accommodations (e.g., comfortable chairs, hand cleansing and toilet facilities, breast pumps) that allow parents to be physically present with the newborn SocialFamily and Community Support: Families do not feel empowered to participate in care while in a facility InternalAttitudes and Beliefs: Providers feel nurturing care behaviors at times challenge their authority or compete rather than complement other care actions in terms of time or resources Attitudes and Beliefs: Nurturing care behaviors are new, and more established providers do not see benefit |
SUPPORTING ACTORS AND ACTIONSWho must support the practice of this behavior, and what actions must they take?InstitutionalPolicymakers: Adopt, clarify, and enforce policies on family-centered, developmentally appropriate care Facility Managers : Identify opportunities to create a more healing environment within facilities Peer Providers : Encourage and support colleagues in adoption of new practices HouseholdFamily Members: Engage more meaningfully in preparations for newborn Family Members: Address traditional gender roles to permit both mothers and fathers to participate in caregiving |
POSSIBLE PROGRAM STRATEGIESWhat strategies will best focus our efforts based on this analysis?Strategy requires Communication Support Enabling EnvironmentInstitutional Capacity Building: Create dedicated newborn care rooms with appropriate lighting and quiet Institutional Capacity Building: Ensure locations for clinical care in facilities include space and facilities for families to participate Institutional Capacity Building: ● Create and disseminate clear policies on required aspects of family-centered developmental care, emphasizing mother-baby dyad care, family engagement in care, consent, and specific components of a healing environment, including clustering clinical care, minimizing painful procedures, providing pain mitigation when necessary, creating a supportive micro-environment (nesting), and maintaining skin integrity Systems, Products and ServicesQuality Improvement: Incorporate training on newborn neurodevelopment in all provider training Quality Improvement: Create exchange programs with providers from facilities with improved nurturing care practices Demand and UseCommunication: Orient and educate parents about nurturing care in the facility and after discharge Communication: Facilitate discussion on newborn neurodevelopment with families during ANC Communication: Empower families to more actively participate in newborn care, including asking questions of providers |
