Figures & Tables
Figures
- FIGURE 1
Implementation Research Approach Timeline for Provider Behavior Change Intervention in Kenya
- FIGURE 2
Providers Reporting Other Providers Involving Parents in Nurturing and Responsive Care Elements, Kenya
Abbreviation: NBU, newborn unit.
- FIGURE 3
Frequency and Length of Provider-Parent Interactions During Young Children's Hospitalization in Kenya
Abbreviation: NBU, newborn unit.
- FIGURE 4
Theory of Change on Enhancing Respectful, Nurturing, and Responsive Care for Sick Young Children Aged 0–24 Months, Kenyaa
a Parent, as described in the figure, denotes family caregiver, guardians, and extended family members.
Tables
- TABLE 1
Characteristics of Providers Participating in Intervention to Improve Care for Hospitalized Young Children in Nairobi and Bungoma Counties, Kenya
Characteristic Pre-Intervention, No. (%)
(n=152)Post-Intervention, No. (%)
(n=103)P Value Providers who were female gender 128 (84.2) 90 (87.4) .481 Providers working in hospital unit Postnatal/maternity ward 30 (19.7) 29 (28.2) .020 Pediatric ward 23 (15.1) 25 (24.3) Nursery/newborn unit 99 (65.1) 49 (47.5) Provider type Doctor/clinical officer 27 (17.8) 14 (13.5) .374 Nurse/midwife 125 (82.2) 90 (86.5) Age of providers, mean (SD), years (mean/SD) 38 (10.2) 39.5 (10.6) .238 Abbreviation: SD, standard deviation.
- TABLE 2.
Characteristics of Mothers of Hospitalized Young Children Participating in Provider Behavior Change Intervention in Nairobi and Bungoma Counties, Kenyaa
Post-Intervention Only, No. (%) Age of respondent, years 15–19 27 (7) 20–24 145 (38) 25–29 116 (30) 30–34 53 (14) >35 43 (11) Level of education Primary and below 120 (31) Secondary education 189 (50) College 73 (19) Marital status Single or divorced 101 (26.4) Married 281 (73.6) Child health status Child recovered/well 367 (97) Baby still unwell 11 (3) Baby died 2 (0.5) Length of hospitalization, days 7.58 (8.39) Child ever separated from parent 318 (83) Ward Nursery/newborn unit 329 (86) Pediatric ward 55 (14) Received information on childcare through intervention, 0–15 index (SD) 11.6 (3.6) Abbreviation: SD, standard deviation.
↵a Follow-up survey.
- TABLE 3.
Knowledge Among Providers on Care of Hospitalized Young Children Pre- and Post-Intervention in Nairobi and Bungoma Counties, Kenya
Provider Knowledge Pre-Intervention Score, Mean (SD) (n=152) Post-Intervention Score, Mean (SD) (n=103) P Value Identifying child's pain and stress (0–7 items) 1.8 (1.2) 1.5 (1.3) .011 Identifying parental stress (0–5 items) 2.5 (1.3) 1.8 (1.3) <.001 Environment stress (0–5 items) 1.3 (1.1) 0.9 (1.1) .001 Optimizing nutrition (0–14 items)a 4.8 (2.2) 4.9 (2.4) .580 Safeguarding sleep (0–12 items)a 3.9 (1.9) 4.7 (2.4) .004 Safeguarding sleep (0–12 items)b 3.9 (2.1) 5.1 (2.4) .0003 Positioning/handling (0–8 items)a 2.3 (1.7) 3.9 (1.9) <.001 Positioning/handling (0–8 items)b 1.8 (1.7) 4.0 (1.7) <.001 Protecting skin (0–10 items)a 4.5 (2.2) 6.2 (2.1) <.001 Protecting skin (0–7 items)b 3.2 (1.4) 4.5 (1.6) <.001 - TABLE 4.
Proportion of Parents Rating Aspects of Provider's Communication Post-Intervention in Nairobi and Bungoma Counties, Kenya
Communication Aspect Post-Intervention, No. (%) (N=382) Greeted you in a friendly way 318 (83.2) Introduced themselves 177 (46.3) Explained any care that was required for your newborn/young child 334 (87.4) Explained why tests were being carried out on your baby 278 (72.8) Demonstrated and give examples while communicating 284 (74.3) Gave mothers a chance to ask questions 324 (84.8) You asked questions 311 (81.4) Felt confident to ask questions about any aspect of your childcare 352 (92.1) Answered your questions clearly using simple language based on responses from earlier question (N=311) 307 (98.7) Explained all the examinations/procedures/tasks that s/he or you performed for your baby 285 (74.6) Used a language you understand 366 (95.8) Spoke gently to you and spouse/family 357 (93.5) Listened carefully when you were talking/raising concerns about your child's care 352 (92.1) Used nonverbal gestures to show you they cared (smile/laughter, eye contact, nodding) 364 (95.3) Clearly explained to you about follow-up instructions for your baby's care 364 (95.3) Told you what to do if you need to reach out to her for any concerns around your child 298 (78.0) Interpersonal communication, overall score (0–16) (SD) 9.5 (6.4) Abbreviation: SD, standard deviation.
- TABLE 5.
Mothers' Empowerment and Ability to Care for Their Young Child Post-Intervention in Nairobi and Bungoma Counties, Kenya
Elements Examined Mothers With Children Hospitalized in Newborn Unit, No. (SD) (n=327) Mothers With Children Hospitalized in Pediatric Ward, No. (SD) (n=55) Overall Score, No. (SD) (n=382) P Value Empowerment score (0–28) 23.2 (3.08) 22.94 (2.92) 23.17 (3.05) .543 Nurturing and responsive care elements Overall ability for parents to provide care for their newborna (0–27) 24.21 (2.69) 23.69 (2.14) 24.13 (2.62) .172 Overall ability for parents to provide care for their young childb (0–20) 18.72 (2.14) 18.54 (1.78) 18.69 (2.09) .567 - TABLE 6.
Associations Between Parents' Self-Reported Outcomes and Receipt of Integrative and Nurturing Care Information Post-Intervention in Nairobi and Bungoma Counties, Kenyaa
Independent Variable Higher Levels of Interpersonal Communication With Providers Parental Empowerment to Care for Children Ability to Provide Responsive Care to Child Received care information through intervention 0.33b 0.28b 0.14c Mother's age, years (ref=15–19) 20–24 0.11 −0.61 1.24 25–29 0.25 −0.62 1.01 30–34 0.18 −0.17 1.74c >35 0.56 0.13 1.47 Level of education (ref=primary and below) Secondary education 0.51 1.02d −0.14 College 0.34 0.74 −0.01 Married/living together (ref= single/divorced) 0.18 0.87c −0.06 Length of hospitalization, days 0.00 −0.01 0.04 Child ever separated from parent (ref=never) 0.72c 0.36c 0.93c Pediatric ward (ref=newborn unit) 1.53d 1.15c −0.95
Supplemental material
- Supplement 1 -
Supplement 1
- Supplement 2 -
Supplement 2
- Supplement 1 -
