UCL Great Ormond Street Institute of Child Health


Great Ormond Street Institute of Child Health


Co-development and piloting of a Family Centred Care model

Project title 
Co-development and piloting of a Family Centred Care model, Kamuzu central Hospital, Malawi

Supervisors names
Prof Michelle Heys
Emma Wilson

Neonatal morbidity and mortality remains a significant global health public challenge, with neonates representing 50% of children under five who are dying (Fleischmann-Struzek, 2018; Institute of Health Metrics, 2017). The leading causes of death for neonates are prematurity, asphyxia, sepsis and congenital defects which all require hospitalisation after birth (WHO). This results in separation between a baby and their parents, resulting in distress which can be perpetuated by the neonatal unit itself (Gomez-Cantarino et al., 2020). 

To support parents, it is essential there is infrastructure in the neonatal unit that allows them to spend time with their babies and includes families in all the care that is rendered to their babies. This can be accomplished through an approach known as family centred care. Family centred care involves planning, delivering, and evaluating healthcare, based on a collaboration with the health care team where parents are viewed as a core component of the baby’s care (Benzies et al, 2019). There are many benefits that are provided by FCC.

These include: a reduction in length of hospital stay, an improvement in neurobehavioral outcomes often seen among premature babies, faster growth as these babies tend to be breastfed accordingly, and reduction in stress levels among parents (Goodling et al., 2011).
However, despite growing evidence of impact relatively little is known about how to deliver Family Centred Care within low income, low resource settings, such as Malawi. 

1.    To understand the enablers and barriers to the delivery of family centered care approach in low-resource settings; 
2.    To adapt  existing models offamily centered care to the Malawian context
3.    To conduct a pilot implementation evaluation of a model of family centred care in Malawi

Kamuzu Central Hospital (KCH) is one the major referral hospitals in Malawi.  It mainly admits patients from the central region and sometimes northern region of Malawi. On average the facility’s neonatal unit admits about 2150 babies per year. 

First, a scoping review will be conducted to identify models of family centered neonatal care and understand key  enablers and barriers to the implementation of family centered care in low resource settings. 
Second, qualitative research (e.g., interviews and focus group discussions ) will be conducted with key stakeholders, health care workers and patients in the Malawian health system  to explore 
(I)    their understanding and perception of partnership working with families for newborn care and 
(ii)     their needs and priorities with regards the adaptation and delivery of family centered clinical pathways in newborn care in this context. 
Third, workshops will be held with key stakeholders to adapt existing models and care pathways to ensure they are appropriate and feasible for this setting. 
Finally, a mixed methods pilot implementation evaluation will be conducted over a 6-month period to explore the feasibility and acceptability of delivering family-centered clinical pathways this setting. This will include collection and analysis of costings data to support the investment case for family centered care.