Infection prevention and control in neonatal units: An ethnographic study of social and clinical interactions among healthcare providers and mothers in Ghana

Gifty Sunkwa-Mills*, Kodjo Senah, Britt Pinkowski Tersbøl

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

2 Citationer (Scopus)
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Abstract

Introduction
Healthcare-associated infections (HAIs) are a global health challenge, particularly in low- and middle-income countries (LMICs). Infection prevention and control (IPC) remains an important strategy for preventing HAIs and improving the quality of care in hospital wards. The social environment and interactions in hospital wards are important in the quest to improve IPC. This study explored care practices and the interactions between healthcare providers and mothers in the neonatal intensive care units (NICU) in two Ghanaian hospitals and discusses the relevance for IPC.

Methodology
This study draws on data from an ethnographic study using in-depth interviews, focus group discussions involving 43 healthcare providers and 72 mothers, and participant observations in the wards between September 2017 and June 2019. The qualitative data were analysed thematically using NVivo 12 to facilitate coding.

Findings
Mothers of hospitalized babies faced various challenges in coping with the hospital environment. Mothers received sparse information about their babies’ medical conditions and felt intimidated in the contact with providers. Mothers strategically positioned themselves as learners, guardians, and peers to enable them to navigate the clinical and social environment of the wards. Mothers feared that persistent requests for information might result in their being labelled “difficult mothers” or might impact the care provided to their babies. Healthcare providers also shifted between various positionings as professionals, caregivers, and gatekeepers, with the tendency to exercise power and maintain control over activities on the ward.

Conclusion
The socio-cultural environment of the wards, with the patterns of interaction and power, reduces priority to IPC as a form of care. Effective promotion and maintenance of hygiene practices require cooperation, and that healthcare providers and mothers find common grounds from which to leverage mutual support and respect, and through this enhance care for mothers and babies, and develop stronger motivation for promoting IPC.
OriginalsprogEngelsk
Artikelnummere0283647
TidsskriftPLoS ONE
Vol/bind18
Udgave nummer7
Antal sider22
ISSN1932-6203
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
This study was supported by the Danish Ministry of Foreign Affairs as part of the HAI-Ghana project (DANIDA grant number 16-PO1-GHA). The funders played no direct role in the study design or preparation of the manuscript.

Publisher Copyright:
Copyright: © 2023 Sunkwa-Mills et al.

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