Evaluating the facilitators and constraints that informed the adaptation of Family Integrated Care to a Ugandan neonatal hospital unit: a qualitative study
Bibliographic record
Abstract
Abstract Background: Family Integrated Care (FICare) is a model of care developed in a Canadian Neonatal Intensive Care Unit that engages parents to be active participants in their infant’s care team. FICare has the potential to have the greatest impact in low-income countries, where the neonatal mortality rate is disproportionately high and the health workforce is severely strained. This manuscript details the facilitators and constraints that informed the adaptation of FICare to a neonatal hospital unit in Uganda Methods: Focus groups of ten mothers and interviews of eight workers were conducted to identify facilitators and constraints to the implementation of FICare in Uganda. Transcripts were analyzed using inductive content analysis. An adaptation team of key stakeholders developed Uganda FICare in the Special Care Nursery in Jinja Regional Referral Hospital based on the results from the focus groups and interviews. Results: The potential to reduce the healthcare provider workload, the desire to empower mothers and the pursuit to improve neonatal outcomes were identified as key facilitators. Maternal difficulty in learning new skills, lack of trust from healthcare providers and increased maternal stress were cited as potential barriers. Uganda FICare focused on task-shifting important but often neglected patient care tasks from healthcare providers to mothers. Healthcare providers were taught how to respond to maternal concerns. All intervention material was adapted to prioritize images over text. Mothers familiar with FICare were encouraged to provide peer-to-peer support and guidance to mothers with newly hospitalized infants. Conclusions: Engaging stakeholders to identify the facilitators and constraints to local implementation is a key step in adapting an intervention to a new context. Uganda FICare shares the core values of the original FICare but is adapted to enhance its feasibility in low-resource settings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.027 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.011 | 0.008 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.002 | 0.007 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".