Putting families first: A new era in childcare in hospitals
In today’s rapidly evolving healthcare landscape, the well-being of a child can no longer be viewed in isolation, especially away from the family that nurtures, protects and understands him/her best. Infants and young children especially depend heavily on their families for comfort, emotional security and communication. As such parents and caregivers are placed at the heart of child care, which is identified as “family centred care”.
Worldwide, family centred care is recognised as a standard in hospitalised childcare. It highlights family as essential partners rather than passive observers at the bedside.
Family centred care is based on a simple yet powerful view: the family is the constant in a child’s life. In this approach, practices such as allowing parents to be present during ward rounds, participate in medical treatment and be involved in decision-making are encouraged. It supports culturally sensitive care by respecting different languages, beliefs and family backgrounds.
By respecting family values, encouraging shared decision-making and strengthening the bond between health staff and families, this approach not only improves health outcomes for children but also builds trust, confidence and continuity of care that lasts far beyond the hospital walls. When healthcare systems actively involve families in planning, delivering and evaluating care, children feel safer, parents feel respected and comfortable and health staff gain valuable insights that improve the quality of care.
Why family involvement matters?
Active involvement of the family plays a vital role in improving both short-term and long-term health outcomes of the child. It is not a one-way process – it requires mutual understanding and cooperation, where families are informed, heard and actively involved in the child’s care.
It also promotes respect, open communication, information sharing and shared decision-making between health staff and families. Parents and caregivers know their child’s habits, fears, preferences and responses better than anyone else. When their knowledge is combined with the clinical expertise of health staff, decisions are more balanced, realistic and tailored to the child’s individual needs. This partnership reduces misunderstandings, improves adherence to treatment plans and minimises unnecessary stress for both the child and the family.
Emotional support is another cornerstone of this approach. Hospitalisation and illness can be frightening experiences for children and deeply distressing for families. Allowing parents to stay with their child, participate in daily care and provide comfort during procedures help reduce anxiety and promote faster recovery. Simple practices such as explaining procedures in understandable language, listening to family concerns and providing mental support can make a significant difference in a child’s healthcare experience.
Family centred care also respects diversity. Families differ in culture, beliefs, language and coping styles. This approach acknowledges these differences and adapts care accordingly, rather than expecting families to fit into rigid systems. By honouring cultural practices and family preferences, healthcare providers create an environment of mutual respect and inclusiveness, important in multicultural societies.
From a long-term perspective, this approach strengthens continuity of care. Families who are well informed and actively involved are better prepared to manage their child’s condition at home, recognize warning signs early and seek timely help. This is particularly important for children with chronic illnesses or special healthcare needs, where ongoing family involvement is essential for successful management and quality of life.
Reality of family centred care in children’s wards in Sri Lanka
Despite a list of benefits, family centred care is often not put into practice fully in hospitals. In many wards, family involvement is limited when treating children. This gap is seen clearly in both low and middle-income countries including Sri Lanka.
In Sri Lanka, routine care often follows a provider-centred model. Treatment decisions are usually made by health staff. Parents are often passive observers at the bedside. Cultural factors also play a role. Many parents hesitate to speak openly with health staff, believing that doctors and nurses know best and that their opinions may not be important.
High patient numbers, lack of staff and busy clinical schedules also limit time for talking with family members. Language barriers can further complicate interactions. Financial difficulties often mean the lack of facilities such as resting areas for parents, education programmes and mental health services.
Stress due to heavy workloads and limited time among health staff may also reduce their ability to engage effectively with families. Flexible hospital policies, such as visitor guidelines that allow parents to stay with their children, are limited in many settings. Physical environments may not always support family comfort or involvement. These challenges highlight a clear gap of its practical implementation in Sri Lanka.
How can we turn ideas into action?
Childcare requires a holistic approach with family involvement as a key component of healing and recovery. Addressing this concern helps ensure that health staff meet professional standards and provide equitable care. It also strengthens relationships between families and health staff, reducing misunderstandings and improving trust.
Several methods can support this process. Training programmes for health staff and families can improve awareness and understanding of family centred care. Developing hospital policies and guidelines that encourage family participation is equally important. Creating formal opportunities for parents to take part in ward rounds, medical discussions and decision-making can make it more practical.
Improving facilities is another important step. Family-friendly wards, flexible visiting policies and facilities to fulfil basic needs for parents can enhance comfort and involvement. Providing financial, social and peer support further strengthens family centred care practices.
Although evidence from developed countries shows clear benefits of family centred care, research in developing countries remains limited. Conducting local research is essential to assess current practices, identify gaps and develop culturally appropriate models for Sri Lanka. The findings can guide training, policy development and planning of family centered care interventions.
Working together for better care for children
Despite its clear benefits, family centred care requires commitment at all levels of the healthcare system. Policies must support family presence, staff must be trained in effective communication, and healthcare environments must be designed to welcome families rather than exclude them. When institutions prioritize efficiency over kindness, families may feel marginalized. Shifting toward a family centered mindset means recognizing that compassion and collaboration healthcare. When families are actively involved in their child’s care in hospital wards, children feel safer and more comfortable, recover faster, and have better overall health outcomes. Strengthening family centred care in children’s wards can therefore greatly improve the well-being of children across the country.
Family centred care is not merely an approach. It is a philosophy that places the child within the context of his/her most important support system: the family. By valuing families as partners, respecting their voices and working together toward shared goals, child healthcare can become more humane, effective and sustainable. Putting families first is not just good practice; it is the right thing to do for every child’s present health and future well-being.
(The writer is a Lecturer in Nursing at the Department of Nursing, Faculty of Allied Health Sciences, University of Ruhuna, Galle)
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