Characterization of Health Care Provider Attitudes Toward Parental Involvement in Neonatal Resuscitation-Related Decision Making in Mongolia
- 219 Downloads
The aim of this study was to characterize attitudes and practices among health care providers (HCPs) in Mongolia regarding parental involvement in neonatal resuscitation (NR)-related decisions. A voluntary, anonymous questionnaire was administered to 210 HCPs across 19 of 21 Mongolia provinces. Eligible HCPs included midwives, neonatologists, pediatricians, and obstetricians involved in neonatal-perinatal care in both rural and urban hospitals. A total of 210 pediatric HCPs were surveyed and 100 % completed all questions (response rate 100 %). Despite the absence of nation-wide guidelines, NR is uniformly performed at 32-weeks gestation across HCP professions and across rural/urban settings. Most HCPs (67 %) indicate that parents should be counseled about resuscitation, but only 9 % ask the parents if they want their extremely premature child resuscitated and only 17 % counsel the parents prior to birth of an at-risk infant. Most HCPs (72 %) prefer to unilaterally decide when to withdraw NR, and only 28 % indicated that both parents should be involved in the decision. Following a newborn’s death, 75 % of all HCPs reported that they do explain the death to parents, although only 28 % reported receiving any training in parental grief counseling. For HCPs in Mongolia, a discrepancy exists between the perceived value of parental involvement and the actual practice of NR-related counseling. This report is a necessary first step toward understanding the factors that influence NR-related practices in Mongolia, and may serve as model for collecting these types of data in other low and middle income countries.
KeywordsNeonatal resuscitation High-risk pregnancy Neonatal intensive care Prematurity Global health
Health care providers
Low and middle income countries
- 3.Wall, S. N., Lee, A. C., & Niermeyer, S., et al. (2009). Neonatal resuscitation in low-resource settings: What, who, and how to overcome challenges to scale up? International Federation of Gynecology and Obstetrics, 107(Suppl 1), S47–S62, S63–S44.Google Scholar
- 5.WHO. (2012). Guidelines on basic newborn resuscitation. In Practical guide (Geneva, Maternal and Newborn Health/Safe Motherhood Unit, Division of Reproductive Health (Technical Support), World Health Organization), p. 61.Google Scholar
- 18.The World Factbook. (2012). (Central Intelligence Agency, Washington, DC). Available from: https://www.cia.gov/library/publications/the-world-factbook/index.html.
- 32.D’Aloja, E., Floris, L., Muller, M., et al. (2010). Shared decision making in neonatology: An utopia or an attainable goal? The Journal of Maternal-Fetal Medicine, 23(Suppl), 356–358.Google Scholar