Global Perspectives of Developmental Care – South Africa

Abstract

2021 • Developmental Observer Neurodevelopmental supportive care in a rainbow nation S Africa, the rainbow country at the tip of the African continent, is home to a population of 65 million people. It is a country that is divided into nine provinces, with 11 official languages and cultural and ethnic diversity. Four major ethnic groups are evident in South Africa with various sub-groups (Department, 2019; SA-V; Statista, 2021). In addition, the country comprises urban, semiurban and rural to deep rural areas. The birth rate for South Africa in 2020 was 19.995 births per 1000 people (Macrotrends, 2021), (1,171,219 births in total for the year 2019) (Department, 2019). In South Africa the preterm birth rate was 12.4% in 2014 representing one out of every ten births (Chawanpaiboon et al., 2019). Premature babies are born and cared for in various economic areas, but care may differ dramatically due to the available human and other resources. Neurodevelopmental supportive care (NDSC) is a widely known but fragmentally implemented care model in the South African context. A variety of researchers from different disciplines conducted studies on various components of NDSC over the last two decades and this article aims to provide an overview of the development and adoption of NDSC in the South African context. The first training on developmental care was presented in 2001 in Pretoria by professional nurse, Sonja Willemse, to a small number of healthcare professionals, consisting primarily of nursing professionals. Thereafter some components were incorporated in neonatal care by individuals, however changing the culture to ensure that neurodevelopmental care became the underlying model of care in all neonatal units across the country, has proven to be challenging. While working in the NICU, I (the author) realised that we, as hospital staff take on the ‘ownership’ of the babies in our care, and parents are not empowered for their parenting role. During 2003, I explored parental needs while their babies were admitted to the NICU in South Africa, with the aim to develop an early intervention program to restore the parenting role for parents while their babies were admitted to the NICU. After completing my master’s degree, I developed the first South African, evidence-based website for parents with preterm infants in NICU: www.littlesteps.co.za (2004). The idea was that we can provide an information platform where information can be updated quickly, and that each unit could have a computer for parents to access the information. This was before smartphones took over the world. The reality for both private and public sector was, that parents only had access to this information from private resources, such as a home computer or internet café. As a result, I started to present preterm parenting workshops for parents in my geographical area, in a format similar to that of ante-natal classes, but with the focus on preterm development and care. Parents’ feedback was that they ‘learned more in four hours than in 60 days in the NICU’ and that ‘staff do not know this information’. I then realised that more must be done to ensure implementation of NDSC in all clinical facilities During 2005, Little Steps, took over the professional 2-day training workshop, expanded it to a 3-day workshop to include preterm feeding, and in 2006 registered the Little Steps Premmies trademark and added an additional training: Little Steps Premmie Parenting Facilitators. I believed that parents in every hospital should have access to information about their premmie’s development and care in a structured format, therefore training more presenters of the parenting workshop seemed like a Global Perspectives of Developmental Care South Africa