“Everyone in this together”: a qualitative study on mothers as partners in infection prevention in a neonatal unit in Botswana
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background
Infection prevention and control (IPC) is critical in neonatal units to prevent healthcare-associated infections, yet research on IPC has primarily focused on healthcare workers, overlooking the role of family caregivers. In low-resource settings, mothers often take on essential caregiving responsibilities including IPC-related tasks, both a logistic necessity and a cultural norm, but their perspectives and experiences remain underexplored. This qualitative descriptive study aimed to explore mothers’ experiences and perceptions of IPC in a neonatal unit in Gaborone, Botswana. Understanding maternal involvement in IPC is essential for developing effective interventions, particularly in settings where health systems face workforce shortages and resource constraints.
Methods
Fifteen semi-structured interviews were conducted with mothers of infants admitted to the neonatal unit between June and December 2022. Data were analysed using thematic analysis.
Results
Six themes were identified. Major themes related to (1) mothers’ strong sense of responsibility for IPC and concerns about infection risks, (2) health system constraints (including supply shortages) that limited consistent IPC practice, (3) competing demands within restricted visiting times that required mothers to balance IPC with feeding and bonding, (4) variable communication with health care workers (HCWs) and limited comfort reminding staff about IPC, and (5) peer dynamics between mothers, including mutual reminders as well as tensions arising from shared feeding equipment. A minor theme that emerged was (6) mothers’ emotional distress and its perceived impact on remembering and enacting IPC behaviours. Overall, mothers described high motivation to protect their infants but reported that time pressures, insufficient communication with HCWs, and resource limitations constrained IPC adherence, underscoring the need for structured IPC orientation and ongoing support for families in neonatal care.
Conclusion
Mothers in this neonatal unit viewed themselves as key partners in IPC and were highly motivated to protect their infants, but their ability to consistently follow IPC practices was constrained by limited supplies, staffing pressures, restricted time for caregiving and bonding, and variable communication with HCWs. Mothers also expressed concerns about HCW adherence to IPC and described how emotional distress and peer dynamics could shape IPC behaviour. These findings underscore the need for structured IPC education and support for mothers in neonatal units, and the importance of integrating family-centred IPC policies into neonatal care. Future research should evaluate interventions that strengthen caregiver support, improve communication, and address contextual barriers and constraints to sustained IPC practice.
Infection prevention and control (IPC) is critical in neonatal units to prevent healthcare-associated infections, yet research on IPC has primarily focused on healthcare workers, overlooking the role of family caregivers. In low-resource settings, mothers often take on essential caregiving responsibilities including IPC-related tasks, both a logistic necessity and a cultural norm, but their perspectives and experiences remain underexplored. This qualitative descriptive study aimed to explore mothers’ experiences and perceptions of IPC in a neonatal unit in Gaborone, Botswana. Understanding maternal involvement in IPC is essential for developing effective interventions, particularly in settings where health systems face workforce shortages and resource constraints.
Methods
Fifteen semi-structured interviews were conducted with mothers of infants admitted to the neonatal unit between June and December 2022. Data were analysed using thematic analysis.
Results
Six themes were identified. Major themes related to (1) mothers’ strong sense of responsibility for IPC and concerns about infection risks, (2) health system constraints (including supply shortages) that limited consistent IPC practice, (3) competing demands within restricted visiting times that required mothers to balance IPC with feeding and bonding, (4) variable communication with health care workers (HCWs) and limited comfort reminding staff about IPC, and (5) peer dynamics between mothers, including mutual reminders as well as tensions arising from shared feeding equipment. A minor theme that emerged was (6) mothers’ emotional distress and its perceived impact on remembering and enacting IPC behaviours. Overall, mothers described high motivation to protect their infants but reported that time pressures, insufficient communication with HCWs, and resource limitations constrained IPC adherence, underscoring the need for structured IPC orientation and ongoing support for families in neonatal care.
Conclusion
Mothers in this neonatal unit viewed themselves as key partners in IPC and were highly motivated to protect their infants, but their ability to consistently follow IPC practices was constrained by limited supplies, staffing pressures, restricted time for caregiving and bonding, and variable communication with HCWs. Mothers also expressed concerns about HCW adherence to IPC and described how emotional distress and peer dynamics could shape IPC behaviour. These findings underscore the need for structured IPC education and support for mothers in neonatal units, and the importance of integrating family-centred IPC policies into neonatal care. Future research should evaluate interventions that strengthen caregiver support, improve communication, and address contextual barriers and constraints to sustained IPC practice.
Date Issued
2026-05-07
Date Acceptance
2026-03-14
Citation
Antimicrobial Resistance and Infection Control, 2026, 15
ISSN
2047-2994
Publisher
BMC
Journal / Book Title
Antimicrobial Resistance and Infection Control
Volume
15
Copyright Statement
© The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/41904569
PII: 10.1186/s13756-026-01734-7
Subjects
Infection prevention and control
antimicrobial resistance
mothers
neonatal unit
neonates
qualitative study
Humans
Botswana
Female
Mothers
Qualitative Research
Adult
Infant, Newborn
Intensive Care Units, Neonatal
Infection Control
Cross Infection
Publication Status
Published
Coverage Spatial
England
Article Number
68
Date Publish Online
2026-03-29