Abstract / Summary
Background: Sudden unexpected infant death (SUID) remains poorly documented in Uganda. We explored parental and community knowledge, perceptions, and practices related to SUID in Uganda. Methods: In 2024, we conducted a qualitative cross-sectional study in Central Uganda involving 41 in-depth interviews (IDI) with mothers (8 cases, 8 controls), fathers (5 cases, 5 controls), and 15 female advisors selected by mothers. Cases were parents who had lost an infant to SUID in the preceding three years; controls were peers of the same gender and location without such experience. We also held six focus group discussions (FGD) with community women and men. Interviews followed a semi-structured guide, were audio-recorded with consent, transcribed verbatim, and thematically analysed using NVivo 14. Results: Knowledge and understanding of SUID: Most participants were aware of infant deaths during sleep but few recognized the term SUID. 2) Perceptions of causes and prevention: Perceived risk factors included suffocation, maternal overlay, inadequate parental care, non-attendance of antenatal care, smoking, alcohol use, and cultural explanations such as witchcraft and extra-marital affairs. 3) Infant care and sleeping practices: Side and prone sleeping positions were common and believed to be safe. Bed-sharing was preferred for breastfeeding convenience and monitoring. Advice on infant care mainly came from experienced family members and health workers. Conclusion: Knowledge of SUID in Uganda is limited, and culturally shaped unsafe sleep practices and misconceptions about risk factors persist. Culturally sensitive, community-based SUID awareness initiatives especially on safe sleep are urgently needed, along with strengthened health worker capacity to deliver SUID prevention messages during routine maternal and child health education.