650 - A qualitative assessment of maternal perspectives on respectful newborn care in Nepal

Publication Number: 3630.650

Henna Shaikh, University of Washington School of Medicine, Seattle, WA, United States; Omkar Basnet, Golden Community, Kathmandu, Bagmati, Nepal; Sujeena Maharjan, Seattle Children's, Lalitpur, Bagmati, Nepal; Sara K. Berkelhamer, University of Washington, Seattle, WA, United States

Background: Respectful maternal and newborn care (RMNC) is a WHO-endorsed human rights imperative that is associated with improved use of healthcare facility services and patient outcomes. Extensive literature characterizes respectful maternity care, however, there is less literature describing respectful newborn care (RNC). In particular, parental perspectives of RNC for healthy and sick newborns in low-resource settings are lacking.

Objective: To qualitatively assess maternal perspectives of RNC for healthy and sick newborns in Bharatpur, Nepal.

Design/Methods: This study was conducted at Bharatpur Hospital, a tertiary government hospital in Bharatpur, Nepal. We recruited a purposive sample of postpartum mothers of healthy and ill newborns by administering a screening questionnaire in the postpartum ward and neonatal intensive care unit (NICU). Mothers who indicated that their newborn had experienced mistreatment were invited to participate in a focus group discussion (FGD) or in-depth interview (IDI) conducted in Nepali by local research staff. FGDs took place in a hospital conference room or local restaurant and IDIs were held at participant homes. Informed consent was obtained. Interviews were recorded, transcribed and translated to English. Transcripts were deductively coded using previously described RMNC typologies, and data that did not fit these themes was inductively coded under new themes.

Results: Twelve mothers of healthy newborns and twelve mothers of infants admitted to the NICU participated in this study. Both groups of mothers were similar in age and parity and tended to be from disadvantageous castes with secondary or higher education (Table 1). Notable FGD and IDI themes included 1) interconnections between respectful maternal a newborn care, 2) mothers’ lack of awareness of medical treatments received by their infants, 3) frequent separation of mother and infant, 4) normative expectations of the healthcare system that enable disrespectful care 5) unsatisfactory health care system conditions, and needs for 6) gentle and attentive care and 7) respectful bereavement care.

Conclusion(s): Though newborns cannot communicate their desires around respectful care, this study demonstrated valuable maternal perspectives. Our findings underscore the importance of considering respectful maternal and newborn care together, improving healthcare facility material resources, and regarding the newborn as a human with dignity, even when ill or dying. This data will be used to monitor RNC and create a workshop curriculum for health care providers.

Characteristics of included mothers
RNC PAS Abstract 2026 Table 1.pdfThis table describes demographic characteristics of mothers who participated in focus groups or in-depth interviews.

Themes and key quotes from focus groups and in-depth interviews
RNC PAS Abstract 2026 Table 2.pdfThis table describes the themes that emerged from analysis of focus group discussion and in-depth interview transcripts along with representative quotes.