Barriers and enablers for practicing kangaroo mother care (KMC) in rural Sindh, Pakistan

Abstract

Background More than 2.5 million newborns die each year, accounting for 47% of children dying worldwide before their age of five years. Complications of preterm birth are the leading cause of death among newborns. Pakistan is amongst the top ten countries with highest preterm birth rate per 1000 live births. Globally, Every Newborn Action Plan (ENAP) has emphasized on Kangaroo Mother Care (KMC) as an essential component of neonatal health initiatives. Materials and methods We conducted this qualitative study with 12 in-depth interviews (IDIs) and 14 focus group discussion (FGD) sessions, in two health facilities of Sindh, Pakistan during October-December 2016, to understand the key barriers and enablers to a mother's ability to practice KMC and the feasibility of implementing and improving these practices. Results The findings revealed that community stakeholders were generally aware of health issues especially related to maternal and neonatal health. Both the health care providers and managers were supportive of implementing KMC in their respective health facilities as well as for continuous use of KMC at household level. In order to initiate KMC at facility level, study respondents emphasized on ensuring availability of equipment, supplies, water-sanitation facility, modified patient ward (e.g., curtain, separate room) and quality of services as well as training of health providers as critical prerequisites. Also in order to continue practicing KMC at household level, engaging the community and establishing functional referral linkage between community and facilities were focused issues in facility and community level FGDs and IDIs. Conclusion The study participants considered it feasible to initiate KMC practice at health facility and to continue practicing at home after returning from facility. Ensuring facility readiness to initiate KMC, improving capacity of health providers both at facility and community levels, coupled with focusing on community mobilization strategy, targeting specific audiences, may help policy makers and program planners to initiate KMC at health facility and keep KMC practice continued at household level.

“It brought hope and peace in my heart:” Caregivers perceptions on kangaroo mother care services in Malawi

“…Not only are husbands and mothers-in-law important household decision-makers that influence the uptake of KMC [ 6 , 11 , 12 ], they are also the backbone of her support network. While KMC is recommended as a feasible and cost-effective intervention for resource-limited settings in comparison with conventional incubator care, this research highlights that the burden of care may be shifted onto mothers and her family to fill the gap created by a lack of human resource [ 24 , 30 ].…”

Facilitating factors and barriers to kangaroo mother care utilisation in low- and middle-income countries: A scoping review

“…The 22 included studies reported on factors influencing and barriers to KMC utilisation amongst PLBWIs mostly published between 2012 and August 2020. The included studies comprised four cross-section studies 36 , 37 , 38 , 39 three randomised control trial studies, 40 , 41 , 42 one explorative study 43 seven descriptive studies, 44 , 45 , 46 , 47 , 48 , 49 , 50 one longitudinal study, 49 one qualitative study, 51 two dissertations 39 , 52 and two formative study. 47 , 53 Almost 10 studies were based on face-to-face interviews, 36 , 37 , 38 , 43 , 44 , 45 , 46 , 47 , 48 , 50 of which seven were qualitative study interviews, 36 , 37 , 43 , 47 , 48 , 50 , 53 three were mixed-method studies 38 , 44 , 46 and nine were quantitative studies.…”

Terceira etapa do método canguru: experiência de mães e profissionais da atenção primária

“…21 In this perspective, a study carried out in Pakistan showed that the support offered by the health professionals to the motherchild binomial was considered a primary factor to ensure KM home follow-up. 22 Regarding this continuity of care, a research study carried out in the province of Quebec pointed out the liaison nurses as being fundamental so that the levels of health care may come to operate as a network, in an articulated and coherent manner. This is possible because the nurses develop actions focused on the needs of the patient and in conjunction with the extra-hospital services, ensuring continuity of care for the patients after hospital discharge.…”