BACKGROUND:
In many low- and middle-income settings, where high neonatal mortality remains a pressing issue, the critical task of detecting early signs of illness falls primarily on parents, who may not be adequately equipped with the knowledge or support to do so with confidence. In Kenya, little is known about parents' knowledge acquisition and care-seeking behaviours, or about effective interventions to support them in recognising illness symptoms.

OBJECTIVES:
To explore the context and social processes influencing Kenyan parents' recognition of neonatal illness and subsequent care-seeking behaviours.

METHODS:
The study applies Charmaz’s constructivist grounded theory approach. Ethical approval was provided by the Liverpool School of Tropical Medicine, UK, and the University of Nairobi, Kenya. In-depth interviews are being conducted with parents of young infants and health professionals, following purposive and theoretical sampling. Non-participant observations of interactions between parents and health professionals are triangulating the findings. Concurrent analysis applies constant comparative methods, coding processes, field notes, and memo writing.

RESULTS:
Data collection began in January 2025, with 70 interviews and 66 observations conducted to date. Emerging findings indicate that systemic and educational shortcomings leave parents poorly equipped with consistent, actionable knowledge, creating critical gaps in their understanding of both normal newborn health and danger signs. As a result, parents seeking care for a sick baby struggle to navigate a complex landscape of conflicting advice, trust judgments, and practical barriers to timely and appropriate care.

CONCLUSIONS:
Our emerging theory suggests that interventions to improve neonatal outcomes must move beyond simple information provision to address the complex interplay of systemic barriers in healthcare, health worker practices, and the social realities parents navigate.

KEY MESSAGE:
The most critical intervention is not merely information, but empowering parents with actionable knowledge—the confidence to understand advice, the trust to believe it, and the systemic support to act on it. Poster session 1 (Group A)