Healthcare worker's views and experiences of factors impacting confidence to provide perinatal bereavement support: a qualitative study in Malawi and Zimbabwe.
Healthcare workers in Malawi and Zimbabwe face significant barriers in providing bereavement support, including feelings of inadequacy and lack of organizational support.
Where it sits
this study against the rest of the survodutide (bi 456906) corpusSummary and findings
This qualitative study explored healthcare workers' views and experiences regarding their confidence to provide bereavement support after stillbirth or neonatal death in Malawi and Zimbabwe. A purposive sample of 66 healthcare workers participated in focus groups and interviews. The findings indicated barriers related to individual feelings of inadequacy and organizational support.
Abstract
Background Worldwide, around 1.9 million babies are stillborn, and 2.5 million newborns die soon after birth annually, the overwhelming majority occur in low- and middle-income countries (LMICs). Perinatal death has devastating impacts for families and communities, but not all parents receive adequate respectful bereavement support. Healthcare workers in LMICs often report that bereavement support is challenging, but few studies have explored factors that impact their confidence to deliver optimal care. Objective To explore healthcare worker's views and experiences of factors impacting their confidence to provide bereavement support to parents after stillbirth or neonatal death in Malawi and Zimbabwe. Methods Using qualitative approaches, a purposive sample of healthcare workers in four maternity facilities in Malawi and Zimbabwe was recruited. Guided by the principles of information power, six dual-moderated focus groups supplemented with eight individual in-depth interviews were conducted. The focus group discussions and interviews were audio-recorded and transcribed verbatim. Data were analyzed using the framework method. Results Sixty-six healthcare workers, including midwives, nurses, service managers, nurse educators, and doctors, participated. Two main themes were identified: (1) 'at least we tried our best' reflecting individual factors including feelings of inadequacy and insufficient education, and (2) 'as a facility we are not quite there yet' characterized by a lack of organizational support, feeling unsupported and a lack of continuing professional development. Conclusion Findings highlight the need to address the individual and environmental barriers to providing support to bereaved women and families. Improving access to pre- and in-service education and training, mentorship and management support are potential solutions.
Background
This paper addresses the challenges faced by healthcare workers in providing bereavement support in low- and middle-income countries, where perinatal death is prevalent. Previous research has indicated that bereavement support is often inadequate, but few studies have focused on the factors influencing healthcare workers' confidence in delivering such support. Understanding these factors is crucial for improving care in these settings.
Methods
The study utilized qualitative methods, recruiting a purposive sample of healthcare workers from four maternity facilities in Malawi and Zimbabwe. A total of 66 participants engaged in six dual-moderated focus groups and eight individual in-depth interviews. Data collection involved audio recording and verbatim transcription, with analysis conducted using the framework method.
Results
The study identified two main themes affecting healthcare workers' confidence: feelings of inadequacy and insufficient education, and a lack of organizational support. Specific numeric findings were not reported in the abstract.
Interpretation
The findings highlight significant barriers that healthcare workers face, which align with existing literature on the challenges of providing bereavement support in similar contexts. While the themes identified are important, the lack of quantitative data limits the ability to assess the magnitude of these issues. The qualitative nature of the study may also introduce subjective bias.
Key findings
- 66 healthcare workers participated, including midwives, nurses, service managers, nurse educators, and doctors.
- Two main themes identified: 'at least we tried our best' and 'as a facility we are not quite there yet'.
Limitations
- Qualitative study, findings may not be generalizable.
- Small sample size of 66 participants.
- Focus on specific regions may limit broader applicability.
- Potential subjective bias in qualitative data.