**5.1 Care of pre-term babies at the community level may be complex and stressful for parents compared to at the health facility with the support of the health care providers and availability of appropriate equipment**

Parents and care takers at home not only require the knowledge about the needs of pre-term babies over and beyond those of the term babies, what medical complications to anticipate and how to prevent them but they also need social structures to support them provide the care to their babies and help with other domestic chores.

Some of the difficulties may vary according to context influenced by culture and traditions. Kangaroo mother care (KMC) for example, has promise to support preterm neonates at home and prevent occurrence of most of the above medical complications, however, its practice has remained low [12]. The traditional way of carrying neonates at the back makes KMC an odd intervention and shameful for mothers to practice [13]. Most communities are aware of the need for warm care for neonates and already have traditional ways of providing it e.g., putting a lamp or a charcoal stove in the room where the neonate sleeps, smearing the body of the neonate with special oils etc. This has made it difficult for KMC to receive social approval in such communities. It has been reported in some studies that community members have accused mothers practicing KMC of using their chests to hide stolen property [14]. This kind of stigmatizing comments from the community members does not only make the mothers fear to practice KMC but also limits the participation of the male partners. It has also been reported that close relatives may generally support and help mothers practicing KMC with household chores, but they are likely to overly subject the mothers to a lot of questions.

Certain traditional practices and norms increase risk of infection among preterm babies such as many care takers in the community not willing to wash hands before handling the neonates, large number of people visiting the mother and the neonate insisting on carrying the baby without washing the hands. Families, therefore, go through a lot of psychological stress from forces within the communities that takes away their confidence while taking care of preterm neonates. The healthcare systems must address this through providing adequate and coordinated information and education.

### **5.2 Gender roles place mothers of preterm babies in responsibility of household chores with limited assistance from the male partners**

Beyond the complexity of detecting medical complications and offering the care needed to prevent them, the mothers in the developing world have additional burden placed on them by gender norms within the societies. It has already been noted that the care for preterm neonates is labor intensive and time consuming and yet in most settings gender roles place the mothers in positions where they receive minimum assistance from their male partners towards household chores. The mothers must cook for their husbands and the other children at home, clean up the house, produce food from the gardens besides having to look after themselves [15].

*Approaches at Community Level for Care of the Preterm Neonates in Low-Income Countries DOI: http://dx.doi.org/10.5772/intechopen.96920*
