Scaling up Kangaroo Mother Care in Ethiopia and India: a multi-site implementation research study.
BMJ Glob Health
; 6(9)2021 09.
Article
en En
| MEDLINE
| ID: mdl-34518203
ABSTRACT
OBJECTIVES:
Kangaroo Mother Care (KMC), prolonged skin-to-skin care of the low birth weight baby with the mother plus exclusive breastfeeding reduces neonatal mortality. Global KMC coverage is low. This study was conducted to develop and evaluate context-adapted implementation models to achieve improved coverage.DESIGN:
This study used mixed-methods applying implementation science to develop an adaptable strategy to improve implementation. Formative research informed the initial model which was refined in three iterative cycles. The models included three components (1) maximising access to KMC-implementing facilities, (2) ensuring KMC initiation and maintenance in facilities and (3) supporting continuation at home postdischarge.PARTICIPANTS:
3804 infants of birth weight under 2000 g who survived the first 3 days, were available in the study area and whose mother resided in the study area. MAIN OUTCOMEMEASURES:
The primary outcomes were coverage of KMC during the 24 hours prior to discharge and at 7 days postdischarge.RESULTS:
Key barriers and solutions were identified for scaling up KMC. The resulting implementation model achieved high population-based coverage. KMC initiation reached 68%-86% of infants in Ethiopian sites and 87% in Indian sites. At discharge, KMC was provided to 68% of infants in Ethiopia and 55% in India. At 7 days postdischarge, KMC was provided to 53%-65% of infants in all sites, except Oromia (38%) and Karnataka (36%).CONCLUSIONS:
This study shows how high coverage of KMC can be achieved using context-adapted models based on implementation science. They were supported by government leadership, health workers' conviction that KMC is the standard of care, women's and families' acceptance of KMC, and changes in infrastructure, policy, skills and practice. TRIAL REGISTRATION NUMBERS ISRCTN12286667; CTRI/2017/07/008988; NCT03098069; NCT03419416; NCT03506698.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Método Madre-Canguro
Tipo de estudio:
Observational_studies
Límite:
Female
/
Humans
/
Newborn
País/Región como asunto:
Africa
/
Asia
Idioma:
En
Revista:
BMJ Glob Health
Año:
2021
Tipo del documento:
Article
País de afiliación:
India