Parents', Families', Communities' and Healthcare Professionals' Experiences of Care Following Neonatal Death in Healthcare Facilities in LMICs: A Systematic Review and Meta-Ethnography.

BACKGROUND: Ninety-eight percent of neonatal deaths worldwide occur in low- and middle-income countries (LMICs), yet there is little bereavement care guidance available for these settings. OBJECTIVES: To explore parents', families' and healthcare professionals' experiences of care after neonatal death in healthcare facilities in LMICs. SEARCH STRATEGY AND SELECTION CRITERIA: Four databases were searched for peer-reviewed literature, meeting the inclusion criteria of qualitative studies exploring the experiences of people who provided or received bereavement care following neonatal death in a LMIC healthcare setting. DATA COLLECTION AND ANALYSIS: Data were collected by two independent reviewers, collated through line-by-line coding and then reciprocal and refutational translation, and analysed through Noblit and Hare's seven-step meta-ethnography approach to create first-, second- and third-order themes. MAIN RESULTS: Seven first-order themes extracted from the literature included emotional responses, social relationships, staff and systems, religion, connecting with the baby, coping strategies and economic concerns. From these data, three third-order themes arose: The individual, the healthcare setting and the community/context. CONCLUSIONS: Overarching themes in bereavement care shape grief responses and are often similar across geographical locations. Analysing these similarities allows a deeper understanding of the important elements of bereavement care and may be helpful to inform the creation of high-quality, bereavement care guidelines suitable for use in LMIC settings.