Parental Satisfaction at Neonatal Intensive Care Units in Public Hospitals of Sidama Regional State, Ethiopia, 2024

Parental Satisfaction at Neonatal Intensive Care Units in Public Hospitals of Sidama Regional State, Ethiopia, 2024 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Parental Satisfaction at Neonatal Intensive Care Units in Public Hospitals of Sidama Regional State, Ethiopia, 2024 Meskerem Jisso, Yemisrach Shifeeraw, Yusuf Haji, Dubale Dulla, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7778980/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: The magnitude of parental stress or depression increases when a newborn faces different health problems after delivery and is admitted to the neonatal intensive care unit (NICU). Therefore, it is necessary to know which care has greater weight and importance to the patients’ parent in order to find ways to improve service quality. Nevertheless, little is known about parents’ satisfaction at NICU. The aim of this study is to assess parental satisfaction and associated factors in neonatal intensive care units at public hospitals of the Sidama region, Ethiopia, 2024. Methods: An institution based cross-sectional study was conducted. A sample of 446 parents of the neonates were enrolled in the study using a multistage sampling technique. The study was done among nine selected governmental hospitals of the Sidama region, Ethiopia. The data were collected using KoBo toolbox. Binary logistic regression analysis was employed to find factors associated with dependent variables. Results: Magnitude of overall parental satisfaction was found to be 55.8% (95% CI: 51.2%, 60.4%). Parental age of below 25 years (AOR = 0.41, 95% CI: (0.22, 0.78)), male parent (AOR = 2.85, 95% CI: 1.67, 4.88), low birth weight (AOR = 0.30, 95% CI: 0.16, 0.54), above seven days of hospital stay (AOR = 0.45, 95% CI: 0.21, 0.95)), parental involvement in the decision-making process on the care of the baby at NICUs (AOR = 4.13, 95% CI: 2.47, 6.91), and history of hospitalization (AOR = 0.33, 95% CI: 0.16, 0.68) were significantly associated factors of parental satisfaction. Conclusion: This study concluded a low level of parental satisfaction. Therefore, it is crucial to provide timely and gender-sensitive neonatal care while enhancing communication between parents and healthcare providers. Neonatal intensive care unit parental satisfaction Sidama region Ethiopia Figures Figure 1 Introduction Effective nursing care, including clear communication, guidance, and education, is essential to enhance parents' confidence and ability to care for their child at home (1). Parental satisfaction is a critical measure of healthcare service quality, reflecting the effectiveness of care delivery (2). Understanding which aspects of care are most important to parents is vital for improving service quality and comparing healthcare outcomes across institutions (3). The stress and emotional burden on parents increase significantly when a newborn faces health challenges such as prematurity, sepsis, or other complications requiring NICU admission. Parental stress often stems from concerns about the infant’s health, uncertain outcomes, changes in their parenting role, and grief over the loss of a healthy child (2). While healthcare providers play a key role in the infant’s care, parents are increasingly recognized as central to promoting their child’s health and well-being. In pediatric care, where communication primarily occurs between providers and parents, parents also play a key role in evaluating the quality of care their child receives (1). International health policies emphasize patient-centered care, advocating for collaborative and participatory interactions between patients (or their families) and healthcare professionals (3). However, studies indicate that parents often struggle to establish harmonious relationships with healthcare providers, partly due to fear or intimidation (4). Humanized care, which treats individuals holistically and empathetically, is linked to better outcomes, whereas non-humanized care, characterized by rigid adherence to hospital rules and a lack of empathy, can negatively impact the care experience (5). The well-being of a child depends not only on physicians and nurses but also on parents, who play a critical role in assessing the quality of care (6). Active parental involvement in clinical decision-making and providing feedback are essential for improving care quality (2) (2,6). Maternal experiences, in particular, are increasingly recognized as valuable in shaping responsive health services, a priority highlighted by the World Health Organization(7). Family-centered care (FCC), defined as interdisciplinary, holistic care that respects the dignity of neonates and their families, is a core strategy for improving outcomes in critically ill infants. FCC acknowledges the vital role of parents in their child’s health during hospitalization and after discharge. Effective communication between nurses and parents is a cornerstone of FCC (5). Ethiopia has made significant efforts to improve its healthcare delivery system, with a strong focus on quality of care. The Federal Ministry of Health (FMOH) has collaborated with stakeholders to promote innovation in healthcare quality management, placing patients at the center of decision-making. The Ethiopian Health Service Alliance for Quality (EHAQ) has prioritized patient satisfaction, with all public hospitals expressing interest in joining this initiative (8). In the NICU setting, where cases are often complex and critical, parental satisfaction serves as a key indicator of service quality. However, satisfaction levels can vary significantly due to differences in the quality and quantity of services provided across regions and hospitals. This study aims to assess parental satisfaction and associated factors in the NICUs. Methodology Study setting The study was conducted among Sidama region governmental hospitals, which is located 275km south of Addis Ababa, capital city of Ethiopia. In this region there are one referral, three general and thirteen district hospitals. In the past ten month there were a total of 392 deaths out of 4325 admission at NICUs. In other words the death rate of the region is 92 deaths per 1,000 live births, which is extremely high as compared to national figure. An institution based cross-sectional study design was employed from April 2023 up to March 30, 2024 . Source population: All parents of the neonates admitted among Sidama region governmental hospitals. Study population: Selected parents of the neonates admitted to NICUs among selected Sidama region governmental hospitals during the study periods Inclusion and exclusion criteria Parents of the neonates who are admitted at governmental NICUs and stayed for at list ≥3 days were included in this study. Parents who are mentally ill and/or critically ill and unable to respond the questions properly and who stayed in the hospital for more than 28 days were excluded from the study. Variables Dependent variable • Parental satisfaction: very satisfied, satisfied and not satisfied Independent variable • Parent/ Client Related Factors: Socio Demographic, frequency of hospitalization, length of Stay • Parent experience towards Health Care Service: Environment: Medical Care, nursing Care, laboratory, pharmacy Sample Size The required sample size was determined using a single population proportion formula by considering the proportion of maternal satisfaction 77 % (18), 0.04 margin of error, and 95% confidence interval: Therefor the final binding sample size is 446. Sampling procedure : From a total of seventeen hospitals (three general, one referral and fourteen district hospitals); three general, one referral and two district hospitals (Hawassa Referal, Adare General, Bona General, Yirgalem General, Daye Primary, and Leku Primary hospitals) were selected by using simple random sampling method. Then final participants were be recruited until the required sample size reached. Data Collection tools and procedures A structured interviewer administered questionnaire and review of medical records, which are adopted from different literatures (12, 19-23), were used to collect data from parents. Parental satisfaction status was measured using a Likert scale with 5 alternatives (1 = Very dissatisfied, 2 = dissatisfied, 3 = normal, 4 = satisfied, 5 = Very satisfied) to measure parental satisfaction status. Before using, the questionnaire pre-taste were conducted. The questionnaire was prepared in English and then translated to Amharic and back to English to maintain consistency. Thirty-six BSc nurses as a data collector (four data collectors in round) and nine general practitioners (doctors) as a supervisor from other health facility were recruited. Data collectors were responsible to interview the parents of a neonate and to review medical records about neonatal outcome and health condition in general. Operational definition Parental satisfaction was assessed using five satisfaction domains with a total of 37questions that includes satisfaction towards information (7 questions), Care and treatment (9 questions), parental participation (6 questions), satisfaction towards organization (6 questions), and satisfaction towards professional attitude (9 questions). Satisfaction for each domain was considered when a parent scored equal or above the mean score of respective satisfaction measuring questions(9,10). Overall parental satisfaction: mean score of all questions (a total of 37) was used to determine overall parental satisfaction. Parents who scored greater or equal to the mean score were considered as satisfied with the care given to their newborn; unless, unsatisfied(9,10) . Data Analysis The data were entered into KoBo software and then imported into SPSS version 27 for cleaning and analysis. Frequency tables, graphs and descriptive summaries were used to present the results Bi-variable logistic regression was also performed to select candidate variables. Those variables with p-value below < 0.25 were selected to do multi-variable logistic regression. Then, multi-variable logistic regression was conducted to all possible confounders. Adjusted odds ratio (aOR) with 95% CI was used as a measure of association, and variables that had a p value less than 0.05 in the multivariate logistic regression were considered as a significantly associated variable. Model fitness was assured through non-significant Hosmer and Lemeshow goodness of fit test. Data quality control Data quality was confirmed during collection, coding, entry and analysis. Training was given for data collectors and supervisor before data collection. In order to identify the questionnaire easily code was given for each questionnaire. Prior to data collection the questionnaires was pretested on 5% of participants in similar setting (Dilla referral Hospital). Day to day monitoring was carried out by supervisors and principal investigators to increase data collection quality and accuracy. Results Socio-demographic characteristics of respondents A total of 446 respondents were enrolled in this study, achieving a 100% response rate. The mean age of the respondents was 26.46 years (±5.01 standard deviation (SD)). Nearly one-fourth of the participants (24.7%) were aged 30 years or older. The majority of respondents (71.1%, n = 317) were female. In terms of education, 30.5% (n = 106) had attained a college degree or higher, while nearly half (48.0%) identified as housewives. Additionally, 38.6% (n = 172) of respondents resided in rural areas. Regarding marital status, the vast majority (93.0%) were married (Table 1). Table 1: Socio-demographic characteristics of respondents at public hospitals of Sidama region, Ethiopia, 2024. variables Categories Frequency Percentage (%) Parents age (in completed years) = 30 110 24.7 Parents sex Male 129 28.9 Female 317 71.1 Educational status No education 26 5.8 Primary 100 22.4 Secondary 184 41.3 Collage and above 136 30.5 Marital status Married 415 93.0 Never married 10 2.2 Divorced/separated/widowed 21 4.7 Occupational status Housewife 214 48.0 Government employee 40 9.0 Privet employee 145 32.5 others @ 47 10.5 Place of residence Rural 172 38.6 Semi urban 126 28.3 Urban 148 33.2 NB: @: Daily laborer, farmer, and student Neonatal and obstetric related characteristics About 59.4% of the newborns were under eight weeks of age. In terms of sex, 53.8% (n = 240) of the neonates were male. The birth weight of the newborns ranged between 1,300 and 5,700 grams, with a mean weight of 2,688.7 grams (±668.7 SD). Nearly three-fourths (74.4%) of the neonates were born at term based on their gestational age. At the time of NICU admission, 28.3% (n = 126) of the neonates were diagnosed with neonatal sepsis. Regarding the duration of hospital stay, three-fourths (74.7%) of the newborns stayed in the NICUs for less than eight days. (Table 2). Table 2: Neonatal profiles at public hospitals of Sidama region, Ethiopia, 2024. variables Categories Frequency Percentage (%) Age of neonate (in days) ≤ 7 265 59.4 8 -14 101 22.6 ≥ 15 80 17.9 Sex of neonate Male 240 53.8 Female 206 46.2 Gestational age Term 332 74.4 Pre-term/post-term 114 25.6 Birth weight (in gram) < 2500 157 35.2 ≥ 2500 289 64.8 Diagnosis at admission Neonatal sepsis 126 28.3 Birth asphyxia 106 23.8 Prematurity 82 18.4 Neonatal jaundice 79 17.7 Respiratory distress 79 17.7 Hypothermia 36 8.1 Other @ 100 22.4 Length of hospital stay ≤ 7days 333 74.7 > 7 days 113 25.3 @: Congenital malformation, Very low birth weight, macrosomia, abscess, congenital stridor, bacterial conjunctivitis, bilateral edema, Breast abscess, failure to breast feed, home delivery, bullous impetigo, low APGAR score, meconium aspirations, nasal bleeding, neonatal meningitis, skin rushes, hemorrhagic anemia, hypoglycemia. 5.2. Healthcare Service Experience and Facility Related Characteristics Most parents (95.3%) received ANC services and 85.4% delivered in a health facility. One in ten (10.8%) of parents had history of hospitalization. Majority (68.8%) of parents get involved in decision making process during care provision (Table 3). Table 3: Experience and facilities related characteristics of parents at public hospitals of Sidama region, Ethiopia, 2024 variables Categories Frequency Percentage (%) ANC for the current baby Yes 425 95.3 No 21 4.7 Number of ANC visit < 4 188 42.2 ≥ 4 237 53.1 Place of delivery Health facility 381 85.4 Home 39 8.7 Health Post 24 5.4 On the way to health facility 2 0.4 Number of attendants involved during care provision ≤ 2 155 34.8 3- 4 215 48.2 ≥ 5 76 17.0 History of hospitalization Yes 48 10.8 No 398 89.2 Parents time home to hospital (walking time) ≤ 60 299 67.0 > 60 147 33.0 Involvement in decision making process Yes 307 68.8 No 139 31.2 Magnitude of parental satisfaction on neonatal care service The overall level of parental satisfaction with neonatal care at public hospitals in the Sidama region was 55.8% (95% CI: 51.2%, 60.4%). When examining the specific domains of parental satisfaction, the highest satisfaction level was observed in the domain of organization (59.2%), while the lowest satisfaction was reported in the domain of participation (52.7%) (Fig. 1). Factors associated with parental satisfaction on neonatal care service After assessing for multicollinearity and controlling for potential confounders, five out of nine variables remained statistically significant in the final model, with a p-value cutoff of less than 0.05. These variables included parental age, where parents aged under 25 years had a 59% lower chance of satisfaction compared to those aged 30 years or older (AOR = 0.41, 95% CI: 0.22, 0.78). Additionally, male parents were 2.85 times more likely to report satisfaction with neonatal care services than female parents (AOR = 2.85, 95% CI: 1.67, 4.88). Parents of neonates weighing less than 2500 grams were found to be 70% less likely to be satisfied compared to those with neonates weighing 2500 grams or more (AOR = 0.30, 95% CI: 0.16, 0.54). Furthermore, parents with a history of hospitalization were 67% less likely to express satisfaction with neonatal care services compared to those without such a history (AOR = 0.33, 95% CI: 0.16, 0.68). Parents who were actively involved in the decision-making process during neonatal care were over four times more likely to be satisfied compared to those who were not involved (AOR = 4.13, 95% CI: 2.47, 6.91). Lastly, parents whose neonates stayed in the hospital for more than seven days were 55% less likely to be satisfied with neonatal care services (AOR = 0.45, 95% CI: 0.21, 0.95). These findings underscore the importance of addressing these factors to improve parental satisfaction in NICUs. (Table 4). Table 4፡Bi-variable and multivariable logistic regression of variables associated with parental satisfaction on neonatal care service in public hospitals of Sidama Regional State, Ethiopia, 2024. Variables Parental Satisfaction COR (95%CI) AOR (95%CI) Unsatisfied Satisfied Age of parents in completed years ≤ 24 87 58 0.25 (0.15, 0.43) 0.41 (0.22, 0.78)* 25 - 29 80 111 0.52 (0.31, 0.87) 0.59 (0.32, 1.08) ≥ 30 30 80 1 1 Sex of parents Male 32 97 3.29 (2.09, 5.19) * 2.85 (1.67, 4.88)* Female 165 152 1 1 Place of residence Rural 67 105 1.37 (0.88, 2.14) 1.44 (0.80, 2.62) Semi urban 61 65 0.93 (0.58, 1.50) 0.96 (0.53, 1.73) Urban 69 79 1 1 Birth weight = 2500 96 193 1 1 Gestational age Term 137 195 1.58 (1.03, 2.43) 0.78 (0.42, 1.44) Pre-term/post term 60 54 1 1 History of hospitalization Yes 28 20 0.53 (0.29, 0.97) 0.33 (0.16, 0.68)* No 169 229 1 1 Involvement in decision making process Yes 100 207 4.78 (3.10, 7.38) 4.13 (2.47, 6.91)* No 97 42 1 1 Parental hospital stay (in days) 7 71 42 0.25 (0.14, 0.46) 0.45 (0.21, 0.95)* Walking time to arrive at hospital (in minute) ≤ 60 144 155 1 1 > 60 53 94 1.65 (1.10, 2.47) 1.65 (0.96, 2.84) Abbreviations: COR, crude odds ratio; AOR, adjusted odds ratio; CI, confidence interval. NB. 1: reference, * remained significant at P-Value <0.05, @ : Daily laborer, farmer, and student Discussion This study aimed to assess parental satisfaction and associated factors in neonatal intensive care units (NICUs) in public hospitals of the Sidama regional state, Ethiopia. The findings revealed that more than half (55.8%, 95% CI: 51.2%, 60.4%) of parents were satisfied with the services provided in NICUs. This result aligns with studies conducted in London, United Kingdom (56%) (11), Indonesia (58.1%) (12), and various regions in Ethiopia, including Bahir Dar (55.0%) (13) and Jimma (57.9%)(9). However, this satisfaction level is higher than that reported in previous studies from Iran (49%)(14) and several Ethiopian locations, such as Gondar (50.0%)(15), and Debre Tabor (47.8%)(10). These discrepancies could be attributed to differences in the timing of the studies, the health care settings and the measurement tools used. Conversely, the satisfaction rate found in this study is lower than those reported in Greece (87.8% and 76.8%) (16,17), Norway (76.0%) (2), Germany (70.0%) (18), Turkey (65.66%)(19),Iran (63.4%)(20) , Debre Birhan (77.0%) (21), and the Southern Nations, Nationalities, and People’s Region (SNNPR) (63.0%)(22). These variations may relate to differences in socio-economic status, quality of healthcare services, and healthcare systems in the respective countries. After controlling for potential confounders in the multivariable logistic regression analysis, associations were established between parental satisfaction and several independent variables, including parental age, parental sex, involvement in decision-making regarding newborn care, duration of hospital stay, and history of hospitalization. Specifically, parents under 25 years had a 58% less likely to be satisfied compared to older age groups. This finding is consistent with previous studies conducted in Norway(2), Greece(23), Nepal (24), Iran(20), Lebanon(25), and various regions of Ethiopia (13,15,26). This trend may be attributed to the higher expectations of healthcare provision among younger parents, which could lead to greater dissatisfaction with the services provided for their newborns. Gender also emerged as a significant factor in parental satisfaction, with male parents nearly three times more likely to report satisfaction compared to female parents. This finding corroborates results from studies in Greece (27), Iran (19), and Bahir Dar, Ethiopia (13). The underlying reason for this association may stem from the tendency of male parents to have lower expectations from healthcare services, leading to higher satisfaction levels. Additionally, the duration of hospital stay was associated with parental satisfaction. Parents whose neonates stayed in the hospital for more than seven days were 55% less likely to be satisfied compared to those whose infants stayed for fewer than four days. This observation aligns with findings from studies in Iran (20), Vietnam(28), and various regions in Ethiopia(13,15,29). The prolonged hospital stays may signal a lack of progress or recovery, contributing to increased dissatisfaction. Parental involvement in decision-making during neonatal care significantly influenced satisfaction levels. Parents who participated in the decision-making process were four times more likely to express satisfaction compared to those who did not. This finding is consistent with studies conducted in London(11), China (30), and Bahir Dar, Ethiopia(13), which highlighted that parental satisfaction is significantly influenced by interactions with healthcare providers during care delivery. Therefore, fostering open communication and shared decision making is crucial between parents and healthcare providers is to enhance satisfaction. Birth weight of the neonate also played a significant role in parental satisfaction. Parents of neonates weighing less than 2500 grams were 70% less likely to be satisfied compared to those with heavier infants. This finding parallels studies conducted in Nepal (24) and DebreTabor, Ethiopia (10), where parents generally expect a healthy newborn, and any devation from this expectation can lead to dissatisfaction. Another factor associated with parental satisfaction was the history of hospitalization. Parents with prior hospitalization experiences were 67% less likely to be satisfied with neonatal care compared to those without such experiences. This finding agrees with previous studies conducted in Iran(20) and Ethiopia(4,13), suggesting that previous negative experiences, such as fatigue, poor memories, and financial burdens from past admissions, may contribute to dissatisfaction. Limitations of the Study While this study aimed to assess one indicator of service quality—parental satisfaction—it is essential to acknowledge certain limitations. First, the study was conducted exclusively in public hospitals, preventing an assessment of parental satisfaction with services provided in private hospitals. Second, since the study is facility-based and focused on admitted newborns, generalizing the results to all newborns may not be appropriate. Third, the cross-sectional design limits the ability to establish causal relationships. Conclusions and Recommendations More than half of the parents in this study reported satisfaction with the services provided for their newborns in NICUs. Factors associated with increased parental satisfaction included being male, involvement in decision-making regarding care, and shorter hospital stays (less than seven days). In contrast, lower satisfaction levels were observed among parents under 25 years of age and those with a history of hospitalization. Therefore, it is recommended to provide timely and gender-sensitive neonatal care while enhancing communication between parents and healthcare providers. Additionally, interventions aimed at increasing public funding for healthcare services should be prioritized. Declarations Ethics Approval and Consent to Participate The study was conducted in accordance with the ethical principles of the Declaration of Helsinki. Ethics permission was obtained from the Institutional Review Board (IRB) of Hawassa University College of Medicine and Health Science with reference number IRB/097/14. Official permission was obtained from the administrative bodies of the hospitals. All parents and guardians gave their verbal informed consent after the study’s objectives and procedures were explained to them. Throughout the study, all participant confidentiality was maintained. in accordance with the Declaration of Helsinki Data Sharing Statement The datasets generated and analyzed during this study are available from the corresponding author upon reasonable request. Funding This research received no specific grant from any funding agencies. Author Contributions The study's conception and design, data collection, analysis, and interpretation were all significantly influenced by the authors. Every author contributed to the manuscript's drafting, made critical revisions for significant intellectual content, gave their approval for the final version to be published, and agreed to take responsibility for every part of the work. Disclosure Regarding the publication of this paper, the authors declare that they have no conflicts of interest. 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BMC Nurs. 2024 Apr 8;23(1):234. Yang Y, Wen M. Correlates of parental satisfaction: a study of late life family relationships in a rural county in China. IJPS. 2024 Aug 26;2(1):53. Nguyen ATB, Nguyen NTK, Phan PH, Van Eeuwijk P, Fink G. Parental satisfaction with quality of neonatal care in different level hospitals: evidence from Vietnam. BMC Health Serv Res. 2020 Dec;20(1):238. Gulo B, Miglierina L, Tognon F, Panunzi S, Tsegaye A, Asnake T, et al. Parents’ Experience and Satisfaction in Neonatal Intensive Care Units in Ethiopia: A Multicenter Cross-Sectional Study Using an Adapted Version of EMPATHIC-N. Front Pediatr. 2021 Oct 8;9:738863. Liu TT, Lei MJ, Li YF, Liu YQ, Meng LN, Jin CD. Effects of parental involvement in infant care in neonatal intensive care units: a meta-analysis. Frontiers of Nursing. 2018 Oct 25;5(3):207–15. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7778980","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":542195564,"identity":"ab830352-9d58-4002-afa4-7d3d1f9c77d3","order_by":0,"name":"Meskerem Jisso","email":"","orcid":"","institution":"Hawassa University","correspondingAuthor":false,"prefix":"","firstName":"Meskerem","middleName":"","lastName":"Jisso","suffix":""},{"id":542195565,"identity":"eeb417d4-02cd-475c-9548-ab0b8a038f53","order_by":1,"name":"Yemisrach Shifeeraw","email":"","orcid":"","institution":"Hawassa University","correspondingAuthor":false,"prefix":"","firstName":"Yemisrach","middleName":"","lastName":"Shifeeraw","suffix":""},{"id":542195566,"identity":"2484a867-0ee7-4feb-a400-6f1b6b8524c9","order_by":2,"name":"Yusuf Haji","email":"","orcid":"","institution":"Hawassa University","correspondingAuthor":false,"prefix":"","firstName":"Yusuf","middleName":"","lastName":"Haji","suffix":""},{"id":542195567,"identity":"829fe146-6703-4a87-927e-10a9bd8b814b","order_by":3,"name":"Dubale Dulla","email":"","orcid":"","institution":"Hawassa University","correspondingAuthor":false,"prefix":"","firstName":"Dubale","middleName":"","lastName":"Dulla","suffix":""},{"id":542195568,"identity":"d8278d2e-ef9c-42bb-a272-c50f7148dd85","order_by":4,"name":"Achamyelesh Gebretsadik","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9ElEQVRIiWNgGAWjYFACHjApA2QwPgYzDxCpBUjyMBvDteDXhtDCJk2UFv72swc/3Wyz4eHnP3usurCNQY7vRgLj4w94tEicyUuWzm1L45GckZd2e2Ybg7HkjQRmA7wOu8FjANRymMfgBo/Zbd42hsQNNxLYJPBpkb/BY/w7t+0/j/35M2bFQC31QC3sP/BpARkOtOUAjwFDjhkzUEuCAdAWvN43PJNjZp1zLplH4kaOsTTPOQnDmWceNkucwaNF7vgZ49s5ZXZy/P1nDD/zlNnI8x1PPvihAo8WMGBkgzMlQNwGQhqA4A8RakbBKBgFo2DkAgAKQUtyjXGOYgAAAABJRU5ErkJggg==","orcid":"","institution":"Hawassa University","correspondingAuthor":true,"prefix":"","firstName":"Achamyelesh","middleName":"","lastName":"Gebretsadik","suffix":""}],"badges":[],"createdAt":"2025-10-04 09:53:13","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7778980/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7778980/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":95662117,"identity":"02b1d8a0-48c8-4562-b7d8-cbc8bdf6fbb2","added_by":"auto","created_at":"2025-11-11 16:37:12","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":78615,"visible":true,"origin":"","legend":"","description":"","filename":"manuscriptonparentalsatisfaction2.docx","url":"https://assets-eu.researchsquare.com/files/rs-7778980/v1/60599cbb13e2451b33c88318.docx"},{"id":95662277,"identity":"427d089e-5109-4f0e-b374-b7adc8f3fcd8","added_by":"auto","created_at":"2025-11-11 16:37:19","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":6997,"visible":true,"origin":"","legend":"","description":"","filename":"10327f02de3040a08a8f29298fc25e2d.json","url":"https://assets-eu.researchsquare.com/files/rs-7778980/v1/16e062b6f30a89033f3c4912.json"},{"id":95662293,"identity":"24634625-e007-4915-90a5-3394fc21da01","added_by":"auto","created_at":"2025-11-11 16:37:20","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":49928,"visible":true,"origin":"","legend":"\u003cp\u003ePercentage distribution of parental satisfaction at public hospitals in Sidama region, Ethiopia, 2024.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7778980/v1/4447bbdb22b3b1c692dcf314.png"},{"id":100698563,"identity":"53504acf-0975-498f-b99a-7c50bf6e0c8c","added_by":"auto","created_at":"2026-01-20 15:27:56","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1093502,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7778980/v1/1850f5cc-0ccc-40d2-9a77-ee2e7e143898.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Parental Satisfaction at Neonatal Intensive Care Units in Public Hospitals of Sidama Regional State, Ethiopia, 2024","fulltext":[{"header":"Introduction","content":"\u003cp\u003eEffective nursing care, including clear communication, guidance, and education, is essential to enhance parents' confidence and ability to care for their child at home\u0026nbsp;(1). Parental satisfaction is a critical measure of healthcare service quality, reflecting the effectiveness of care delivery\u0026nbsp;(2). Understanding which aspects of care are most important to parents is vital for improving service quality and comparing healthcare outcomes across institutions\u0026nbsp;(3).\u003c/p\u003e\n\u003cp\u003eThe stress and emotional burden on parents increase significantly when a newborn faces health challenges such as prematurity, sepsis, or other complications requiring NICU admission. Parental stress often stems from concerns about the infant’s health, uncertain outcomes, changes in their parenting role, and grief over the loss of a healthy child\u0026nbsp;(2). While healthcare providers play a key role in the infant’s care, parents are increasingly recognized as central to promoting their child’s health and well-being. In pediatric care, where communication primarily occurs between providers and parents, parents \u0026nbsp;also play a key role in evaluating the quality of care their child receives\u0026nbsp;(1).\u003c/p\u003e\n\u003cp\u003eInternational health policies emphasize patient-centered care, advocating for collaborative and participatory interactions between patients (or their families) and healthcare professionals\u0026nbsp;(3). However, studies indicate that parents often struggle to establish harmonious relationships with healthcare providers, partly due to fear or intimidation\u0026nbsp;(4). Humanized care, which treats individuals holistically and empathetically, is linked to better outcomes, whereas non-humanized care, characterized by rigid adherence to hospital rules and a lack of empathy, can negatively impact the care experience\u0026nbsp;(5).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe well-being of a child depends not only on physicians and nurses but also on parents, who play a critical role in assessing the quality of care\u0026nbsp;(6). Active parental involvement in clinical decision-making and providing feedback are essential for improving care quality\u0026nbsp;(2)\u003c/p\u003e\n\u003cp\u003e(2,6). Maternal experiences, in particular, are increasingly recognized as valuable in shaping responsive health services, a priority highlighted by the World Health Organization(7).\u003c/p\u003e\n\u003cp\u003eFamily-centered care (FCC), defined as interdisciplinary, holistic care that respects the dignity of neonates and their families, is a core strategy for improving outcomes in critically ill infants. FCC acknowledges the vital role of parents in their child’s health during hospitalization and after discharge. Effective communication between nurses and parents is a cornerstone of FCC\u0026nbsp;(5).\u003c/p\u003e\n\u003cp\u003eEthiopia has made significant efforts to improve its healthcare delivery system, with a strong focus on quality of care. The Federal Ministry of Health (FMOH) has collaborated with stakeholders to promote innovation in healthcare quality management, placing patients at the center of decision-making. The Ethiopian Health Service Alliance for Quality (EHAQ) has prioritized patient satisfaction, with all public hospitals expressing interest in joining this initiative\u0026nbsp;(8).\u003c/p\u003e\n\u003cp\u003eIn the NICU setting, where cases are often complex and critical, parental satisfaction serves as a key indicator of service quality. However, satisfaction levels can vary significantly due to differences in the quality and quantity of services provided across regions and hospitals. This study aims to assess parental satisfaction and associated factors in the NICUs.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cp\u003e\u003cstrong\u003eStudy setting\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted among Sidama region governmental hospitals, which is located 275km south of Addis Ababa, capital city of Ethiopia. In this region there are one referral, three general and thirteen district hospitals. In the past ten month there were a total of 392 deaths out of 4325 admission at NICUs. In other words the death rate of the region is 92 deaths per 1,000 live births, which is extremely high as compared to national figure.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAn institution based cross-sectional study design was employed from April 2023 up to March 30, 2024\u003cstrong\u003e.\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSource population:\u003c/strong\u003e All parents of the neonates admitted among Sidama region governmental hospitals.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy population:\u003c/strong\u003e Selected parents of the neonates admitted to NICUs among selected Sidama region governmental hospitals during the study periods\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eInclusion and exclusion criteria\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eParents of the neonates who are admitted at governmental NICUs and stayed for at list ≥3 days were included in this study.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Parents who are mentally ill and/or critically ill and unable to respond the questions properly and who stayed in the hospital for more than 28 days were excluded from the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eVariables\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDependent variable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e• Parental satisfaction: very satisfied, satisfied and not satisfied\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIndependent variable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e• Parent/ Client Related Factors: Socio Demographic, frequency of hospitalization, length of Stay • Parent experience towards Health Care Service: Environment: Medical Care, nursing Care, laboratory, pharmacy\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample Size\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe required sample size was determined using a single population proportion formula by considering the proportion of maternal satisfaction 77 % (18), 0.04 margin of error, and 95% confidence interval: Therefor the final binding sample size is 446.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSampling procedure\u003c/strong\u003e:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;From a total of seventeen hospitals (three general, one referral and fourteen district hospitals); three general, one referral and two district hospitals (Hawassa Referal, Adare General, Bona General, Yirgalem General, Daye Primary, and Leku Primary hospitals) were selected by using simple random sampling method. Then final participants were be recruited until the required sample size reached.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eData Collection tools and procedures\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA structured interviewer administered questionnaire and review of medical records, which are adopted from different literatures (12, 19-23), were used to collect data from parents. Parental satisfaction status was measured using a Likert scale with 5 alternatives (1 = Very dissatisfied, 2 = dissatisfied, 3 = normal, 4 = satisfied, 5 = Very satisfied) to measure parental satisfaction status. Before using, the questionnaire pre-taste were conducted. The questionnaire was prepared in English and then translated to Amharic and back to English to maintain consistency. Thirty-six BSc nurses as a data collector (four data collectors in round) and nine general practitioners (doctors) as a supervisor from other health facility were recruited.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eData collectors were responsible to interview the parents of a neonate and to review medical records about neonatal outcome and health condition in general. Operational definition Parental satisfaction was assessed using five satisfaction domains with a total of 37questions that includes satisfaction towards information (7 questions), Care and treatment (9 questions), parental participation (6 questions), satisfaction towards organization (6 questions), and satisfaction towards professional attitude (9 questions). Satisfaction for each domain was considered when a parent scored equal or above the mean score of respective satisfaction measuring questions(9,10). Overall parental satisfaction: mean score of all questions (a total of 37) was used to determine overall parental satisfaction. Parents who scored greater or equal to the mean score were considered as satisfied with the care given to their newborn; unless, unsatisfied(9,10) .\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Analysis\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data were entered into KoBo software and then imported into SPSS version 27 for cleaning and analysis. Frequency tables, graphs and descriptive summaries were used to present the results Bi-variable logistic regression was also performed to select candidate variables. Those variables with p-value below \u0026lt; 0.25 were selected to do multi-variable logistic regression. Then, multi-variable logistic regression was conducted to all possible confounders. Adjusted odds ratio (aOR) with 95% CI was used as a measure of association, and variables that had a p value less than 0.05 in the multivariate logistic regression were considered as a significantly associated variable. Model fitness was assured through non-significant Hosmer and Lemeshow goodness of fit test.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData quality control\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData quality was confirmed during collection, coding, entry and analysis. Training was given for data collectors and supervisor before data collection. In order to identify the questionnaire easily code was given for each questionnaire. Prior to data collection the questionnaires was pretested on 5% of participants in similar setting (Dilla referral Hospital). Day to day monitoring was carried out by supervisors and principal investigators to increase data collection quality and accuracy.\u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eSocio-demographic characteristics of respondents\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 446 respondents were enrolled in this study, achieving a 100% response rate. The mean age of the respondents was 26.46 years (\u0026plusmn;5.01 standard deviation (SD)). Nearly one-fourth of the participants (24.7%) were aged 30 years or older. The majority of respondents (71.1%, n = 317) were female. In terms of education, 30.5% (n = 106) had attained a college degree or higher, while nearly half (48.0%) identified as housewives. Additionally, 38.6% (n = 172) of respondents resided in rural areas. Regarding marital status, the vast majority (93.0%) were married (Table 1).\u003c/p\u003e\n\u003cp\u003eTable 1: Socio-demographic characteristics of respondents at public hospitals of Sidama region, Ethiopia, 2024.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003evariables\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eParents age (in completed years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;= 24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25-29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e191\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e42.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;= 30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eParents sex\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e317\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e71.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eEducational status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e22.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e184\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e41.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCollage and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eMarital status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e415\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e93.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNever married\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDivorced/separated/widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eOccupational status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHousewife\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e214\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e48.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGovernment employee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePrivet employee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eothers\u003csup\u003e@\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003ePlace of residence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e172\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e38.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSemi urban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e33.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNB: @: Daily laborer, farmer, and student\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNeonatal and obstetric related characteristics\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAbout 59.4% of the newborns were under eight weeks of age. In terms of sex, 53.8% (n = 240) of the neonates were male. The birth weight of the newborns ranged between 1,300 and 5,700 grams, with a mean weight of 2,688.7 grams (\u0026plusmn;668.7 SD). Nearly three-fourths (74.4%) of the neonates were born at term based on their gestational age. At the time of NICU admission, 28.3% (n = 126) of the neonates were diagnosed with neonatal sepsis. Regarding the duration of hospital stay, three-fourths (74.7%) of the newborns stayed in the NICUs for less than eight days. (Table 2).\u003c/p\u003e\n\u003cp\u003eTable 2: Neonatal profiles at public hospitals of Sidama region, Ethiopia, 2024.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003evariables\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eAge of neonate (in days)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026le; 7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e265\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e59.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8 -14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e22.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ge; 15\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eSex of neonate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e240\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e53.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e206\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e46.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eGestational age\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTerm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e332\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e74.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePre-term/post-term\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eBirth weight (in gram)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt; 2500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e35.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ge; 2500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e289\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e64.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003eDiagnosis at admission\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNeonatal sepsis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBirth asphyxia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e23.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePrematurity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNeonatal jaundice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRespiratory distress\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHypothermia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOther\u003csup\u003e@\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e22.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eLength of hospital stay\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026le; \u0026nbsp;7days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e333\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e74.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt; 7 days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e113\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e@: Congenital malformation, Very low birth weight, macrosomia, abscess, congenital stridor, bacterial conjunctivitis, bilateral edema, Breast abscess, failure to breast feed, home delivery, bullous impetigo, low APGAR score, meconium aspirations, nasal bleeding, neonatal meningitis, skin rushes, hemorrhagic anemia, hypoglycemia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e5.2. Healthcare Service Experience and Facility Related Characteristics\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMost parents (95.3%) received ANC services and 85.4% delivered in a health facility. One in ten (10.8%) of parents had history of hospitalization. Majority (68.8%) of parents get involved in decision making process during care provision (Table 3).\u003c/p\u003e\n\u003cp\u003eTable 3: Experience and facilities related characteristics of parents at public hospitals of Sidama region, Ethiopia, 2024\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003evariables\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eANC for the current baby\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e425\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e95.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eNumber of ANC visit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt; 4\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e188\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e42.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ge; 4\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e237\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e53.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePlace of delivery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHealth facility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e381\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e85.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHealth Post\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOn the way to health facility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eNumber of attendants involved during care provision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026le; 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e34.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3- 4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e215\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e48.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ge; 5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eHistory of hospitalization\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e398\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e89.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eParents time home to hospital (walking time)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026le; \u0026nbsp;60\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e299\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e67.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt; 60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e33.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eInvolvement in decision making process\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e307\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e68.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e31.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eMagnitude of parental satisfaction on neonatal care service\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe overall level of parental satisfaction with neonatal care at public hospitals in the Sidama region was 55.8% (95% CI: 51.2%, 60.4%). When examining the specific domains of parental satisfaction, the highest satisfaction level was observed in the domain of \u003cem\u003eorganization\u003c/em\u003e (59.2%), while the lowest satisfaction was reported in the domain of participation (52.7%) (Fig. 1).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFactors associated with parental satisfaction on neonatal care service\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAfter assessing for multicollinearity and controlling for potential confounders, five out of nine variables remained statistically significant in the final model, with a p-value cutoff of less than 0.05. These variables included parental age, where parents aged under 25 years had a 59% lower chance of satisfaction compared to those aged 30 years or older (AOR = 0.41, 95% CI: 0.22, 0.78). Additionally, male parents were 2.85 times more likely to report satisfaction with neonatal care services than female parents (AOR = 2.85, 95% CI: 1.67, 4.88). Parents of neonates weighing less than 2500 grams were found to be 70% less likely to be satisfied compared to those with neonates weighing 2500 grams or more (AOR = 0.30, 95% CI: 0.16, 0.54).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Furthermore, parents with a history of hospitalization were 67% less likely to express satisfaction with neonatal care services compared to those without such a history (AOR = 0.33, 95% CI: 0.16, 0.68). Parents who were actively involved in the decision-making process during neonatal care were over four times more likely to be satisfied compared to those who were not involved (AOR = 4.13, 95% CI: 2.47, 6.91). Lastly, parents whose neonates stayed in the hospital for more than seven days were 55% less likely to be satisfied with neonatal care services (AOR = 0.45, 95% CI: 0.21, 0.95). These findings underscore the importance of addressing these factors to improve parental satisfaction in NICUs. (Table 4).\u003c/p\u003e\n\u003cp\u003eTable 4፡Bi-variable and multivariable logistic regression of variables associated with parental satisfaction on neonatal care service in public hospitals of Sidama Regional State, Ethiopia, 2024.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"596\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eParental Satisfaction\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCOR (95%CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAOR (95%CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnsatisfied\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSatisfied\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge of parents in completed years \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026le; 24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.25 (0.15, 0.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.41 (0.22, 0.78)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25 - 29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.52 (0.31, 0.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.59 (0.32, 1.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ge; 30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex of parents\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.29 (2.09, 5.19) *\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.85 (1.67, 4.88)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e165\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of residence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.37 (0.88, 2.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.44 (0.80, 2.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSemi urban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.93 (0.58, 1.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.96 (0.53, 1.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eBirth weight\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;2500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.28 (0.18, 0.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.30 (0.16, 0.54)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;= 2500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e193\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGestational age\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTerm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e195\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.58 (1.03, 2.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.78 (0.42, 1.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePre-term/post term\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHistory of hospitalization\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.53 (0.29, 0.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.33 (0.16, 0.68)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e169\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e229\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eInvolvement in decision making process\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e207\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.78 (3.10, 7.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.13 (2.47, 6.91)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eParental hospital stay (in days)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4-7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.62(0.39, 1.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.64 (0.35, 1.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.25 (0.14, 0.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.45 (0.21, 0.95)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eWalking time to arrive at hospital (in minute)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026le; 60\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e144\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt; 60\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.65 (1.10, 2.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.65 (0.96, 2.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviations: COR, crude odds ratio; AOR, adjusted odds ratio; CI, confidence interval.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNB. 1: reference, * remained significant at P-Value \u0026lt;0.05, \u003csup\u003e@\u003c/sup\u003e: Daily laborer, farmer, and student\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study aimed to assess parental satisfaction and associated factors in neonatal intensive care units (NICUs) in public hospitals of the Sidama regional state, Ethiopia. The findings revealed that more than half (55.8%, 95% CI: 51.2%, 60.4%) of parents were satisfied with the services provided in NICUs. This result aligns with studies conducted in London, United Kingdom (56%) (11), Indonesia (58.1%) (12), and various regions in Ethiopia, including Bahir Dar (55.0%) (13) and Jimma (57.9%)(9). However, this satisfaction level is higher than that reported in previous studies from Iran (49%)(14) \u0026nbsp;and several Ethiopian locations, such as Gondar (50.0%)(15), and Debre Tabor (47.8%)(10). These discrepancies could be attributed to differences in the timing of the studies, the health care settings and the measurement tools used. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConversely, the satisfaction rate found in this study is lower than those reported in Greece (87.8% and 76.8%) (16,17), Norway (76.0%) (2), Germany (70.0%) (18), Turkey (65.66%)(19),Iran (63.4%)(20) , Debre Birhan (77.0%) (21), and the Southern Nations, Nationalities, and People’s Region (SNNPR) (63.0%)(22). These variations may relate to differences in socio-economic status, quality of healthcare services, and healthcare systems in the respective countries.\u003c/p\u003e\n\u003cp\u003eAfter controlling for potential confounders in the multivariable logistic regression analysis, associations were established between parental satisfaction and several independent variables, including parental age, parental sex, involvement in decision-making regarding newborn care, duration of hospital stay, and history of hospitalization. Specifically, parents under 25 years had a 58% less likely to be satisfied compared to older age groups. This finding is consistent with previous studies conducted in Norway(2), Greece(23), Nepal (24), Iran(20), Lebanon(25), and various regions of Ethiopia (13,15,26). This trend may be attributed to the higher expectations of healthcare provision among younger parents, which could lead to greater dissatisfaction with the services provided for their newborns.\u003c/p\u003e\n\u003cp\u003eGender also emerged as a significant factor in parental satisfaction, with male parents nearly three times more likely to report satisfaction compared to female parents. This finding corroborates results from studies in Greece (27), Iran (19), and Bahir Dar, Ethiopia (13). The underlying reason for this association may stem from the tendency of male parents to have lower expectations from healthcare services, leading to higher satisfaction levels.\u003c/p\u003e\n\u003cp\u003eAdditionally, the duration of hospital stay was associated with parental satisfaction. Parents whose neonates stayed in the hospital for more than seven days were 55% less likely to be satisfied compared to those whose infants stayed for fewer than four days. This observation aligns with findings from studies in \u0026nbsp;Iran (20), Vietnam(28), and various regions in Ethiopia(13,15,29). The prolonged hospital stays may signal a lack of progress or recovery, contributing to increased dissatisfaction.\u003c/p\u003e\n\u003cp\u003eParental involvement in decision-making during neonatal care significantly influenced satisfaction levels. Parents who participated in the decision-making process were four times more likely to express satisfaction compared to those who did not. This finding is consistent with studies conducted in London(11), China (30), and Bahir Dar, Ethiopia(13), which highlighted that parental satisfaction is significantly influenced by interactions with healthcare providers during care delivery. Therefore, fostering open communication and shared decision making is crucial between parents and healthcare providers is to enhance satisfaction.\u003c/p\u003e\n\u003cp\u003eBirth weight of the neonate also played a significant role in parental satisfaction. Parents of neonates weighing less than 2500 grams were 70% less likely to be satisfied compared to those with heavier infants. This finding parallels studies conducted in Nepal (24) and DebreTabor, Ethiopia (10), where parents generally expect a healthy newborn, and any devation from this expectation can lead to dissatisfaction.\u003c/p\u003e\n\u003cp\u003eAnother factor associated with parental satisfaction was the history of hospitalization. Parents with prior hospitalization experiences were 67% less likely to be satisfied with neonatal care compared to those without such experiences. This finding agrees with previous studies conducted in Iran(20) \u0026nbsp;and Ethiopia(4,13), suggesting that previous negative experiences, such as fatigue, poor memories, and financial burdens from past admissions, may contribute to dissatisfaction.\u003c/p\u003e\n\u003ch2\u003eLimitations of the Study\u003c/h2\u003e\n\u003cp\u003eWhile this study aimed to assess one indicator of service quality—parental satisfaction—it is essential to acknowledge certain limitations. First, the study was conducted exclusively in public hospitals, preventing an assessment of parental satisfaction with services provided in private hospitals. Second, since the study is facility-based and focused on admitted newborns, generalizing the results to all newborns may not be appropriate. Third, the cross-sectional design limits the ability to establish causal relationships.\u003c/p\u003e"},{"header":"Conclusions and Recommendations","content":"\u003cp\u003eMore than half of the parents in this study reported satisfaction with the services provided for their newborns in NICUs. Factors associated with increased parental satisfaction included being male, involvement in decision-making regarding care, and shorter hospital stays (less than seven days). In contrast, lower satisfaction levels were observed among parents under 25 years of age and those with a history of hospitalization. Therefore, it is recommended to provide timely and gender-sensitive neonatal care while enhancing communication between parents and healthcare providers. Additionally, interventions aimed at increasing public funding for healthcare services should be prioritized.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted in accordance with the ethical principles of the Declaration of Helsinki. Ethics permission was obtained from the Institutional Review Board (IRB) of Hawassa University College of Medicine and Health Science with reference number IRB/097/14. Official permission was obtained from the administrative bodies of the hospitals. All parents and guardians gave their verbal informed consent after the study’s objectives and procedures were explained to them. Throughout the study, all participant confidentiality was maintained.\u0026nbsp;in accordance with the Declaration of Helsinki\u003cbr\u003e\u0026nbsp;\u003cstrong\u003eData Sharing Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and analyzed during this study are available from the corresponding author upon reasonable request.\u0026nbsp;\u003cbr\u003e\u0026nbsp;\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no specific grant from any funding agencies.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study's conception and design, data collection, analysis, and interpretation were all significantly influenced by the authors. Every author contributed to the manuscript's drafting, made critical revisions for significant intellectual content, gave their approval for the final version to be published, and agreed to take responsibility for every part of the work.\u0026nbsp;\u003cbr\u003e\u003cstrong\u003e\u003cbr\u003e\u0026nbsp;Disclosure\u003c/strong\u003e\u0026nbsp;\u003cbr\u003e\u0026nbsp;Regarding the publication of this paper, the authors declare that they have no conflicts of interest.\u0026nbsp;\u003cbr\u003e\u0026nbsp;\u003cstrong\u003eAcknowledgment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank the research and collaborative office at Hawassa University, the parents who took part in this study, and the NICUs staff for their assistance in gathering data.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eLake ET, Smith JG, Staiger DO, Hatfield LA, Cramer E, Kalisch BJ, et al. Parent Satisfaction With Care and Treatment Relates to Missed Nursing Care in Neonatal Intensive Care Units. Front Pediatr. 2020 Mar 18;8:74.\u003c/li\u003e\n\u003cli\u003eHagen IH, Iversen VC, Nesset E, Orner R, Svindseth MF. Parental satisfaction with neonatal intensive care units: a quantitative cross-sectional study. BMC Health Serv Res. 2019 Dec;19(1):37.\u003c/li\u003e\n\u003cli\u003eHagen IH, Svindseth MF, Nesset E, Orner R, Iversen VC. Validation of the Neonatal Satisfaction Survey (NSS-8) in six Norwegian neonatal intensive care units: a quantitative cross-sectional study. BMC Health Serv Res. 2018 Dec;18(1):222.\u003c/li\u003e\n\u003cli\u003eMulugeta H, Wagnew F, Dessie G, Biresaw H, Habtewold TD. Patient satisfaction with nursing care in Ethiopia: a systematic review and meta-analysis. BMC Nurs. 2019 Dec;18(1):27.\u003c/li\u003e\n\u003cli\u003eYu YT, Hsieh WS, Hsu CH, Lin YJ, Lin CH, Hsieh S, et al. Family-centered Care Improved Neonatal Medical and Neurobehavioral Outcomes in Preterm Infants: Randomized Controlled Trial. Physical Therapy. 2017 Dec 1;97(12):1158\u0026ndash;68.\u003c/li\u003e\n\u003cli\u003eCooper LG, Gooding JS, Gallagher J, Sternesky L, Ledsky R, Berns SD. Impact of a family-centered care initiative on NICU care, staff and families. J Perinatol. 2007 Dec;27(S2):S32\u0026ndash;7.\u003c/li\u003e\n\u003cli\u003eLake ET, Smith JG, Staiger DO, Schoenauer KM, Rogowski JA. Measuring Parent Satisfaction With Care in Neonatal Intensive Care Units: The EMPATHIC-NICU-USA Questionnaire. Front Pediatr. 2020 Oct 6;8:541573.\u003c/li\u003e\n\u003cli\u003eHealth sector transformation in quality : A guide to transform the quality of health care in Ethiopia. Addis Ababa, Ethiopia: MINISTRY OF HEALTH, 2016 Contract No.: Version 1. In.\u003c/li\u003e\n\u003cli\u003eAdal Z, Atomsa G, Tulu G. 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Frontiers of Nursing. 2018 Oct 25;5(3):207\u0026ndash;15.\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Neonatal intensive care unit, parental satisfaction, Sidama region, Ethiopia","lastPublishedDoi":"10.21203/rs.3.rs-7778980/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7778980/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e The magnitude of parental stress or depression increases when a newborn faces different health problems after delivery and is admitted to the neonatal intensive care unit (NICU). Therefore, it is necessary to know which care has greater weight and importance to the patients’ parent in order to find ways to improve service quality. Nevertheless, little is known about parents’ satisfaction at NICU. The aim of this study is to assess parental satisfaction and associated factors in neonatal intensive care units at public hospitals of the Sidama region, Ethiopia, 2024.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e An institution based cross-sectional study was conducted. A sample of 446 parents of the neonates were enrolled in the study using a multistage sampling technique. The study was done among nine selected governmental hospitals of the Sidama region, Ethiopia. The data were collected using KoBo toolbox. Binary logistic regression analysis was employed to find factors associated with dependent variables.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eMagnitude of overall parental satisfaction was found to be 55.8% (95% CI: 51.2%, 60.4%). Parental age of below 25 years (AOR = 0.41, 95% CI: (0.22, 0.78)), male parent (AOR = 2.85, 95% CI: 1.67, 4.88), low birth weight (AOR = 0.30, 95% CI: 0.16, 0.54), above seven days of hospital stay (AOR = 0.45, 95% CI: 0.21, 0.95)), parental involvement in the decision-making process on the care of the baby at NICUs (AOR = 4.13, 95% CI: 2.47, 6.91), and history of hospitalization (AOR = 0.33, 95% CI: 0.16, 0.68) were significantly associated factors of parental satisfaction.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eThis study concluded a low level of parental satisfaction. Therefore, it is crucial to provide timely and gender-sensitive neonatal care while enhancing communication between parents and healthcare providers.\u003c/p\u003e","manuscriptTitle":"Parental Satisfaction at Neonatal Intensive Care Units in Public Hospitals of Sidama Regional State, Ethiopia, 2024","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-11 16:21:07","doi":"10.21203/rs.3.rs-7778980/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"69ae2e63-d973-4208-b0a9-921b899cf41b","owner":[],"postedDate":"November 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-01-20T12:45:32+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-11 16:21:07","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7778980","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7778980","identity":"rs-7778980","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}