Family-Centered Care to Complement Care of Sick Newborns: A Randomized Controlled Trial.

OBJECTIVE To assess the impact of family-centered care in delivery of care to sick newborns, on nosocomial infection rate. DESIGN Randomized controlled trial. SETTING Tertiary referral nursery (October 2010 to March 2012). PARTICIPANTS 295 neonates randomized at the time of hospitalization in neonatal intensive care unit. INTERVENTION Parent-attendant of intervention group were trained using an indigenously developed and pretested, culturally sensitive, simple audio-video tool that covered domains of personal hygiene, hand washing, danger signs recognition and feeding of sick neonate. Control group received routine care by nurses and doctors. OUTCOME MEASURE Primary: culture positive nosocomial infection rate. Secondary: culture negative nosocomial infection rate, duration of hospitalization, mortality and breastfeeding rate. RESULTS Two-thirds of family caregivers were fathers/ mothers and about 20% were grandparents. About 60% of family care givers were either illiterate (25%) or primary/middle pass (34%). Incidence of nosocomial episodes of sepsis was not different between groups (incidence rate difference 0.74, 95 % CI -4.21, 5.6, P = 0.76). Pre-discharge exclusive breastfeeding rates were significantly higher in intervention group [80.4% vs 66.7% (P=0.007)]. CONCLUSION There was no significant difference in nosocomial infection rate between the two groups. Translating and adapting principles of family-centered care was feasible, and improved the pre-discharge exclusive breastfeeding rates.