Maternal Care Practices for Preterm Infants after Discharge from Two Teaching Hospitals in Port Harcourt, Nigeria: A Mixed-Methods Approach

References

[1] Adama, E., Sundin, D., & Bayes, S. (2020). Sociocultural practices affecting the care of preterm infants in the Ghanaian Community. Journal of Transcultural Nursing, 2020(1), 1043659620975098.

[2] Adu-Bonsaffoh, K., Oppong, S., Dassah, E., & Seffah, J. (2020). Challenges in preterm birth research: Ghanaian perspective. Placenta, 98(1), 24–28.

[3] Agbeno, E., Osarfo, J., Ashong, J., Anane-Fenin, B., Okai, E., Ofori, A., & Soltani, H. (2021). Determinants of preterm survival in a teaching hospital in Ghana: A ten-year review. PLOS ONE, 16(1), e0246005.

[4] Baughcum, A., Powers, S., Johnson, S., Chamberlin, L. A., Deeks, C., Jain, A., & Whitaker, R. (2001). Maternal feeding practices and beliefs and their relationships to overweight in early childhood. Journal of Developmental & Behavioural Pediatrics, 22(6), 391-408.

[5] Bolarinwa, O. (2020). Sample size estimation for health and social science researchers: The principles and considerations for different study designs. Nigeria Postgraduate Medical Journal, 27(1), 67-75.

[6] Celebi-Celik, F., Tuzun, F., Duman, N., Keskinoglu, P., Kumral, A., & Ozkan, H. (2021). Current factors affecting the risk of omphalitis in newborns: A prospective case‐control study. International Journal of Clinical Practice, 75(5), e14071.

[7] Charan, J., & Biswas, T. (2013). How to calculate sample size for different study designs in medical research. Indian Journal of Psychological Medicine, 35(2), 121-126. https://doi.org/10.4103/0253-7176.116232.

[8] Charpak, N., Montealegre‐Pomar, A., & Bohorquez, A. (2021). Systematic review and meta‐analysis suggest that the duration of Kangaroo mother care has a direct impact on neonatal growth. Acta Paediatrica, 110(1), 45-59.

[9] Dawczynski, K., Schleussner, E., Dobermann, H., & Proquitte, H. (2016). Infection prevention in premature infants and newborns in Thuringia: implementation of recommendation of the commission for hospital hygiene and infection prevention (KRINKO). Zeitschrift fur Geburtshilfe und Neonatologie, 221(1), 30-38.

[10] Esewe, R. E., & Phetlhu, R. D. (2022). Challenges of uptake of kangaroo mother care by parents of preterm and low birth weight infants in Edo State, Nigeria. African Journal of Reproductive Health, 26(2), 68-79.

[11] Fernandez-Turienzo, C., Silverio, S. A., Coxon, K., Brigante, L., Seed, P. T., Shennan, A. H., ... & POPPIE Collaborative Group. (2021). Experiences of maternity care among women at increased risk of preterm birth receiving midwifery continuity of care compared to women receiving standard care: Results from the POPPIE pilot trial. PloS one, 16(4), e0248588.

[12] Garti, I., Donkor, E., Musah, N., Appiah, E., Gyekye, S., Menlah, A., & Akuoko, C. (2021). Mothers’ experiences of caring for preterm babies at home: Qualitative insights from an urban setting in a middle-income country. BMC Pregnancy and Childbirth, 21(1), 395.

[13] Getie, B., Yismaw, A., & Tiguh, A. (2022). Kangaroo mother care knowledge and practice among mothers who gave birth to preterm and low birth weight babies in Amhara regional state referral hospitals, North West Ethiopia. International Journal of Africa Nursing Sciences , 17(1), 100470.

[14] Hägi-Pedersen, M., Dessau, R., Norlyk, A., Stanchev, H., & Kronborg, H. (2022). Comparison of video and in-hospital consultations during early in-home care for premature infants and their families: A randomised trial. Journal of Telemedicine and Telecare, 28(1), 24-36.

[15] Hsieh, H., & Shannon, E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9), 1277-1288.

[16] Jiang, X., & Jiang, H. (2022). Factors associated with post SCBU discharge exclusive breastfeeding rate and duration amongst first time mothers of preterm infants in Shanghai: a longitudinal cohort study. International Breastfeeding Journal, 17(1), 1-18.

[17] Johnson, J. O. (2024). Implementation of Family Centered Care for Neonates Admitted in a Special Care Baby Unit in Sierra Leone. Pediatric Health, Medicine and Therapeutics, 189-199.

[18] Kalito, J. D., Masumo, M. M., & Fabian, C. (2024). Acceptability of Kangaroo Mother Care (KMC) by Mothers with Low-Birth-Weight Babies at Arthur Davison Children’s Hospital, in Ndola, Zambia. Open Journal of Obstetrics and Gynecology, 14(5), 790-823.

[19] Knappett, M., Nguyen, V., Chaudhry, M., Trawin, J., Kabakyenga, J., Kumbakumba, E., ... & Wiens, M. O. (2024). Pediatric post-discharge mortality in resource-poor countries: a systematic review and meta-analysis. EClinicalMedicine, 67(1), e102380.

[20] López-Medina, M., López-Araque, A., Linares-Abad, M., & López-Medina, I. (2020). Umbilical cord separation time, predictors and healing complications in newborns with dry care. PLoS One, 15(1), e0227209. https://doi.org/10.1371/journal.pone.0227209.

[21] Maastrup, R., Rom, A., Walloee, S., Sandfeld, H., & Kronborg, H. (2021). Improved exclusive breastfeeding rates in preterm infants after a neonatal nurse training program focusing on six breastfeeding-supportive clinical practices. PLoS ONE, 16(2), e0245273.

[22] Maluni, J., Oluoch, D., Molyneux, S., Boga, M., Jones, C., Murila, F., ... & Hinton, L. (2025). After neonatal care, what next? A qualitative study of mothers’ post-discharge experiences after premature birth in Kenya. International Journal for Equity in Health, 24(1), e17.

[23] MÓ§relius, E., Kling, K., Haraldsson, E., & Alehagen, S. (2020). You can’t flight, you need to fight—A qualitative study of mothers’ experiences of feeding extremely preterm infants. Journal of Clinical Nursing, 29(13–14), 2420–2428.

[24] Mustapha, B., Simon, P., Abdullahi, B., & Abubakar, H. (2020). Prevalence and associated morbidities of preterm neonatal admissions at the University of Maiduguri Teaching Hospital, North-Eastern Nigeria. Nigerian Journal of Paediatrics, 47(3), 264-269.

[25] Nnagbo, J. E., Ugwu, G. O., Eze, M. I., Agu, P. U., Nnagbo, C. L., Udealor, P. C., ... & Ezegwui, H. U. (2024). Incidence, Determinants, and Outcomes of Spontaneous Preterm Birth at Tertiary Hospitals in Enugu, Southeast, Nigeria: A Cross-Sectional Study. Nigerian Journal of Clinical Practice, 27(2), 228-235.

[26] Nsubuga, R., Rujumba, J., Nyende, S., Kisaka, S., Idro, R., & Nankunda, J. (2024). Predictors of mortality among low birth weight neonates after hospital discharge in a low-resource setting: A case study in Uganda. Plos One, 19(6), e0303454.

[27] Nyandiko, W., Kiptoon, P., & Lubuya, F. (2021). Neonatal hypothermia and adherence to World Health Organisation thermal care guidelines among newborns at Moi Teaching and Referral Hospital, Kenya . PLoS ONE, 16(3), e0248838.

[28] Opoto, E. W., Ogaji, D. S., Ugege, E. O., Eleke, C., & Samuel, J. C. (2024). Maternal Care of Preterm Infants after Discharge from the Neonatal Intensive Care Unit: A Rapid Review. International Journal of Medicine and Health Development, 29(4), 277-284.

[29] Shwe, D. D., Afolaranmi, T. O., Egbodo, C. O., Musa, J., Oguche, S., & Bode-Thomas, F. (2021). Methylated spirit versus chlorhexidine gel: A randomized non-inferiority trial for prevention of neonatal umbilical cord infection in Jos, North-Central Nigeria. Nigerian Journal of Clinical Practice, 24(5), 762-769.

[30] Sivanandan, S., & Sankar, M. J. (2023). Kangaroo mother care for preterm or low birth weight infants: a systematic review and meta-analysis. BMJ Global Health, 8(6), e010728.

[31] Udeogalanya, E. A. (2023). Neonatal Home-Care Practices of Mothers in Ihiala Local Government Area of Anambra State. Saudi Journal of Nursing and Health Care, 6(12), 461-472.

[32] Yuan, M., Long, Y., Liu, T., Liu, J., Qiu, S., Lin, T., ... & Fang, Y. (2024). Soft electronics for advanced infant monitoring. Materials Today, 75(1), 166-186.

[33] Zini, M., & Omo-Aghoja, L. (2019). Clinical sociodemographic correlates of preterm deliveries in two teaching hospitals in southern Nigeria. Ghana Medical Journal, 53(1), 20-28.

@article{1707819,
      author = {Elvorah Wilson Opoto, MSN, Daprim Samuel Ogaji, PhD, Elsie Ososese Ugege, PhD, Prof. Peace Opara},
      title = {Maternal Care Practices for Preterm Infants after Discharge from Two Teaching Hospitals in Port Harcourt, Nigeria: A Mixed-Methods Approach},
      journal = {Iconic Research And Engineering Journals},
      year = {2025},
      volume = {8},
      number = {10},
      pages = {339-351},
      issn = {2456-8880},
      url = {https://www.irejournals.com/formatedpaper/1707819.pdf},
      abstract = {Preterm infants require specialized care following discharge from the Special Care Baby Unit (SCBU). Mothers are expected to learn and practice thermal care (Kangaroo Mother Care, KMC), exclusive breastfeeding (EBF), hand hygiene (infection control), and growth monitoring/vigilance. However, there is scarcity of evidence on the practices by mothers in specific geographical and cultural contexts.
Aim: To examine maternal care practices for preterm infants at 3- and 6-months post-discharge from SCBUs in two teaching hospitals in Port Harcourt. 
Methods: A convergent parallel mixed-method design was employed. The qualitative arm included 30 mothers, selected via purposive sampling, while the quantitative arm followed 170 mother-infant pairs using consecutive sampling. Data were collected through interviews and a validated self-report questionnaire (r = 0.81). Thematic content analysis (Hsieh & Shannon approach) was used for qualitative data, while descriptive and chi-square statistics (5% significance level) were applied to quantitative data using NVivo and SPSS 25, respectively.
 Results: Fifteen themes and 46 subthemes emerged from qualitative analysis. Between 3- and 6-months post-discharge, EBF declined significantly from 97.0% to 77.7%, KMC from 68.9% to 39.2%, and hand hygiene from 92.2% to 41.6%, while growth monitoring remained stable. EBF reduced morbidity risk by 92% (RR = 0.08, p < 0.001), and weekly growth monitoring reduced risk by 87% (RR = 0.13, p = 0.002). 
Conclusion: Maternal adherence to EBF, KMC, and hand hygiene declined significantly by 6 months post-discharge. Strengthening public health education is essential to sustain optimal preterm infant care practices.},
      keywords = {Breast Feeding, Hand Hygiene, Infant, Kangaroo-Mother Care Method, Mothers, Premature},
      month = {April},
  }