Characterization of health care provider attitudes toward parental involvement in neonatal resuscitation-related decision making in Mongolia

The aim of this study was to characterize attitudes and practices among health care providers (HCPs) in Mongolia regarding parental involvement in neonatal resuscitation (NR)-related decisions. A voluntary, anonymous questionnaire was administered to 210 HCPs across 19 of 21 Mongolia provinces. Eligible HCPs included midwives, neonatologists, pediatricians, and obstetricians involved in neonatal-perinatal care in both rural and urban hospitals. A total of 210 pediatric HCPs were surveyed and 100% completed all questions (response rate 100%). Despite the absence of nation-wide guidelines, NR is uniformly performed at 32-weeks gestation across HCP professions and across rural/urban settings. Most HCPs (67%) indicate that parents should be counseled about resuscitation, but only 9% ask the parents if they want their extremely premature child resuscitated and only 17% counsel the parents prior to birth of an at-risk infant. Most HCPs (72%) prefer to unilaterally decide when to withdraw NR, and only 28% indicated that both parents should be involved in the decision. Following a newborn's death, 75% of all HCPs reported that they do explain the death to parents, although only 28% reported receiving any training in parental grief counseling. For HCPs in Mongolia, a discrepancy exists between the perceived value of parental involvement and the actual practice of NR-related counseling. This report is a necessary first step toward understanding the factors that influence NR-related practices in Mongolia, and may serve as model for collecting these types of data in other low and middle income countries. Keywords Neonatal resuscitation * High-risk pregnancy * Neonatal intensive care * Prematurity * Global health
Introduction Neonatal resuscitation (NR) has the potential to save lives and prevent morbidity [1]. Basic NR steps that can be performed in any setting include drying and positioning the infant, [...]