Maternal knowledge and clinically relevant care gaps in preterm infant care in Gaza, Palestine: a cross-sectional study.

BACKGROUND

Mothers of premature infants need practical knowledge to support feeding, thermal care, infection prevention, phototherapy safety and discharge preparation. Evidence on domain-specific maternal knowledge in resource-constrained neonatal settings remains limited. This study assessed maternal knowledge of premature infant care in Gaza and explored clinically relevant item-level knowledge gaps to inform future education priorities.

METHODS

A cross-sectional survey was conducted among 170 mothers of premature infants admitted to neonatal departments in four government hospitals in the Gaza Strip. A 30-item interviewer-administered questionnaire assessed knowledge across thermoregulation, feeding, phototherapy, and infection and skin care. Descriptive, bivariate and adjusted regression analyses were conducted, with exploratory item-level analyses used to identify clinically relevant knowledge gaps.

RESULTS

Overall knowledge was moderate, with a mean score of 64.1% (SD = 22.3), but 53 mothers (31.2%) had poor knowledge. Knowledge differed across domains (p < 0.001), with feeding the weakest domain (53.6%) and infection and skin care the highest by observed percentage score (73.8%). In the parsimonious adjusted model, not receiving specialist premature-care antenatal follow-up was associated with lower odds of higher knowledge (adjusted OR = 0.44, 95% CI 0.20-0.97, p = 0.042). Item-level findings showed clinically relevant gaps in feeding tolerance, nil per os (NPO) management, nasogastric tube (NGT) feeding, phototherapy safety, handling practices and umbilical cord care.

CONCLUSIONS

Although overall maternal knowledge was moderate, this masked clinically important gaps in practical caregiving domains, particularly feeding, phototherapy safety, handling practices and umbilical cord care. Given the cross-sectional design, findings should not be interpreted causally. These findings may inform the development and future evaluation of domain-specific education tools for antenatal counselling, bedside teaching and discharge preparation in similar constrained neonatal settings.