Farrell Sarah, Mills Tracey A, Lavender Dame Tina
Centre for Childbirth, Women's, and Newborn Health, International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK.
Glob Health Action. 2025 Dec;18(1):2450137. doi: 10.1080/16549716.2025.2450137. Epub 2025 Feb 3.
Sub-Saharan Africa shoulders much of the global burden of neonatal mortality. Quality postnatal care is often lacking due to availability, accessibility, mistrust of health systems, and socio-economic barriers, yet delays in care-seeking contribute to avoidable neonatal deaths. Research highlights the urgent need for improved health education about neonatal illness; however, contextual factors are rarely considered, and few interventions have been implemented.
To critically examine the literature on parents' knowledge of neonatal illness and care-seeking behaviour and evaluate interventions supporting parental understanding in sub-Saharan African Great Lakes countries.
Systematic searches were conducted in CINAHL, MEDLINE, Global Health, the Cochrane Library, and thesis repositories. Studies meeting inclusion criteria were critically analysed using Whittemore and Knafl's framework, and quality was assessed with Hawker et al.'s tool, following PRISMA guidelines.
Seventy studies (48 quantitative, 14 qualitative, eight mixed methods) were reviewed. The first theme, "poor knowledge of neonatal illness", showed parents struggled to recognise illness, with knowledge affected by maternity and socio-economic factors. The second theme, "sub-optimal healthcare-seeking behaviour", highlighted delayed care-seeking due to cultural, social, and economic factors. Finally, "strategies to support parents' understanding" emphasised the roles of community workers, health education phone calls, SMS, and videos, and neonatal monitoring systems.
Parental knowledge of neonatal illness is generally low, and care-seeking is influenced by beliefs, trust in healthcare, and logistical challenges. While community health workers and multi-media interventions appear effective, health education efforts must address contextual barriers and beliefs to improve recognition and care-seeking for neonatal illness.
撒哈拉以南非洲承担着全球新生儿死亡的大部分负担。由于服务可及性、可获得性、对卫生系统的不信任以及社会经济障碍，往往缺乏高质量的产后护理，然而寻求护理的延迟导致了可避免的新生儿死亡。研究强调迫切需要改善关于新生儿疾病的健康教育；然而，很少考虑背景因素，并且很少实施干预措施。
批判性地审视关于父母对新生儿疾病的认识及寻求护理行为的文献，并评估支持撒哈拉以南非洲大湖地区国家父母理解的干预措施。
在护理学与健康领域数据库（CINAHL）、医学文献数据库（MEDLINE）、全球健康数据库、考克兰图书馆和论文库中进行系统检索。使用惠特莫尔和克纳夫的框架对符合纳入标准的研究进行批判性分析，并按照系统评价和荟萃分析优先报告的条目声明（PRISMA）指南，用霍克等人的工具评估质量。
共审查了70项研究（48项定量研究、14项定性研究、8项混合方法研究）。第一个主题“对新生儿疾病的了解不足”表明，父母难以识别疾病，其知识受到孕产妇和社会经济因素的影响。第二个主题“次优的医疗寻求行为”强调了由于文化、社会和经济因素导致的寻求护理延迟。最后，“支持父母理解的策略”强调了社区工作者、健康教育电话、短信、视频以及新生儿监测系统的作用。
父母对新生儿疾病的了解普遍较低，寻求护理受到信念、对医疗保健的信任以及后勤挑战的影响。虽然社区卫生工作者和多媒体干预措施似乎有效，但健康教育工作必须解决背景障碍和信念问题，以提高对新生儿疾病的识别和寻求护理的能力。
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