Family-Centered Care to Complement Care of Sick Newborns: A Randomized Controlled Trial.

OBJECTIVE: To assess the impact of family-centered care in delivery of care to sick newborns, on nosocomial infection rate.

DESIGN: Randomized controlled trial.

SETTING: Tertiary referral nursery (October 2010 to March 2012).

PARTICIPANTS: 295 neonates randomized at the time of hospitalization in neonatal intensive care unit.

INTERVENTION: Parent-attendant of intervention group were trained using an indigenously developed and pretested, culturally sensitive, simple audio-video tool that covered domains of personal hygiene, hand washing, danger signs recognition and feeding of sick neonate. Control group received routine care by nurses and doctors.

OUTCOME MEASURE: Primary: culture positive nosocomial infection rate. Secondary: culture negative nosocomial infection rate, duration of hospitalization, mortality and breastfeeding rate.

RESULTS: Two-thirds of family caregivers were fathers/ mothers and about 20% were grandparents. About 60% of family care givers were either illiterate (25%) or primary/middle pass (34%). Incidence of nosocomial episodes of sepsis was not different between groups (incidence rate difference 0.74, 95 % CI -4.21, 5.6, P = 0.76). Pre-discharge exclusive breastfeeding rates were significantly higher in intervention group [80.4% vs 66.7% (P=0.007)].

CONCLUSION: There was no significant difference in nosocomial infection rate between the two groups. Translating and adapting principles of family-centered care was feasible, and improved the pre-discharge exclusive breastfeeding rates.