Parental Satisfaction with Neonatal Care in Tertiary Hospitals: The Role of the Care Environment, a Cross-Sectional Study

Background Parental satisfaction serves as a vital indicator of quality in neonatal wards and reflects the effectiveness of care delivery. Quality improvement studies generate evidence that can shape best practices and strengthen neonatal services within specific settings. This study examined parental satisfaction with neonatal care and explored service delivery gaps to guide targeted interventions for improved outcomes. Methods This was a cross-sectional study that evaluated parent–neonate dyads in tertiary hospitals in Nigeria. Parental experiences were assessed using a modified EMPATHIC-30 questionnaire. Optimal satisfaction was defined as a mean score ≥ 4/5 (80%). Bivariate and multivariable analyses identified predictors of overall satisfaction, reported as odds ratios with 95% confidence intervals. Results A total of 503 mother–baby dyads were enrolled, with a male predominance (311; 61.8%). 64.6% of mothers were primary caregivers, and 76.7% of families were of middle socioeconomic status. Overall, 443 parents or caregivers (88.1%) were satisfied with the care and facilities. Proportions reporting optimal scores across care domains were: communication (78.3%), family-centered care (77.5%), emotional support and compassion (79.7%), clinical care and professionalism (81.3%), quality of care and treatment (86.3%), environment and infrastructure (47.1%), organization (80.1%), and administrative process (77.3%). Bivariate analysis showed significant associations between satisfaction and newborn sex, caregiver type, family status, maternal employment status and the care domains. In multivariable analysis, a daughter baby was associated with lower satisfaction (aOR = 0.241; 95% CI: 0.089–0.655; p = 0.005). Predictors of higher satisfaction included family-centered care (aOR = 11.770; 95% CI: 3.579–38.707; p < 0.001), emotional support and compassion (aOR = 4.750; 95% CI: 1.271–17.755; p = 0.002), quality of care and treatment (aOR = 4.347; 95% CI: 1.053–17.946; p = 0.004) and satisfaction with nurses’ performance (aOR = 32.839; 95% CI: 10.086–106.923; p < 0.001). Conclusion While overall satisfaction with newborn care in tertiary hospitals in Nigeria was high, parents and caregivers identified notable gaps in the physical environment. Targeted improvements in these areas are essential to enhance caregiver experience and improve the overall quality of neonatal care.