Supporting fathers’ involvement in neonatal care: A systems-based investigation

Contemporary models of neonatal care recognise the importance of involving both birthing and non-birthing parents equally in their infant’s care. However, this has not yet become routine practice, and fathers are often left peripheral to care delivery. Previous studies have identified individual barriers and tested interventions within neonatal units, but they have not taken a systems approach to understand how the many factors influencing father involvement interact or how broader social and structural conditions shape fathers’ capacity to engage. Using a systems thinking approach, this study aimed to understand these connections and draw on the perspectives of fathers, their partners, and healthcare providers to identify ways to better support fathers in neonatal care.

Parents described fathers’ involvement in neonatal care as influenced by a range of interconnected factors at the individual, family, healthcare provider, and hospital levels. Parents identified several priority areas for improving involvement, including better communication between staff and fathers, greater access to the hospital, emotional and practical support from staff, and support to help fathers manage responsibilities outside the hospital. While the highest-priority strategies were either outside the scope of neonatal staff (e.g., neonatal-specific paid parental leave) or considered difficult to implement because of resource constraints (e.g., accommodation for families within the neonatal unit), other strategies — such as father peer support and staff training — were considered feasible by staff.

While some low-cost strategies (e.g., peer support) could be implemented by individual neonatal units to better support fathers, meaningful and widespread improvements are likely to require broader structural reforms, including increased hospital resources and neonatal-specific paid parental leave. Together, these top-down policy changes and bottom-up, local initiatives offer complementary ways to improve father involvement and support better outcomes for infants, parents, and families.