Developmentally Supportive and Family Participatory Care in Special Newborn Care Units: A Review of Global Evidence, Implementation Models, and the Indian Context

ABSTRACT: Globally, an estimated 2.3 million neonatal deaths occur annually, with over 90% concentrated in low- and middle-income countries (LMICs). As survival among preterm and low birth weight infants improves, there is a growing need to ensure survival with quality. Developmentally supportive care (DSC) and family participatory care (FPC) have emerged as evidence-based approaches that enhance neurodevelopment, reduce stress, and strengthen caregiver involvement, although their implementation in LMICs remains variable. This narrative review with systematic search strategy synthesizes global and Indian evidence on DSC and FPC, outlines key implementation models, and highlights contextual innovations and future priorities. A narrative review with systematic search strategy was conducted using PubMed, Scopus, WHO IRIS, Cochrane Library, UNICEF repositories, and Google Scholar. Eligible studies included human research evaluating DSC or FPC interventions in neonatal intensive care unit/special newborn care unit settings. Case reports, commentaries, and nonempirical studies were excluded. Evidence was synthesized thematically across developmental care, family engagement, health-system readiness, and clinical outcomes. DSC interventions, including protected sleep, positioning, sensory regulation, and pain mitigation, demonstrated improvements in neurodevelopment, breastfeeding, weight gain, and parental satisfaction. Family integrated care/FPC models from Canada, Australia, China, and India showed reduced parental stress, improved breastfeeding and growth, and, in some settings, lower infection rates and shorter hospital stay. Integration of kangaroo mother care (KMC/immediate KMC) further enhanced bonding and survival outcomes. India's policy frameworks (India Newborn Action Plan, LaQshya, and National Quality Assurance Standards) and state-led programs support contextual adaptation. DSC and FPC are essential components of high-quality neonatal care. Scalable, evidence-informed models such as India's DSC-FPC approach can advance national and global goals for neonatal survival and neurodevelopment.