Facilitating factors and barriers to accessibility and utilization of kangaroo mother care service among parents of low birth weight infants in Mangochi District, Malawi: a qualitative study

Abstract

Background Kangaroo Mother Care (KMC) is one of the interventions widely used in low-income countries to manage Low Birth Weight Infants (LBWIs), a global leading cause of neonatal and child mortality. LBWI largely contributes to neonatal mortality in Malawi despite the country strengthening and implementing KMC, nationwide, to enhance the survival of LBWIs. This qualitative study aimed to assess the facilitating factors and barriers to accessibility and utilization of KMC service by the parent of low birth weight infants (PLBWIs) in Mangochi District, Malawi. Methods Two focused group discussions assessed factors facilitating and hindering the accessibility and utilization of KMC service were conducted in April 2018 that reached out to ( N = 12) participants; (n:6) PLBWI practicing KMC at Mangochi district hospital (MDH) referred from four health facilities and (n:6) high-risk pregnant mothers (HRPMs) visiting antenatal care (ANC) clinic at MDH. The availability of KMC at MDH was assessed using KMC availability checklist. The study used purposive, convenient and simple random sampling to identify eligible participants. Thematic analysis was used to analyze the findings. Results Sixteen themes emerged on facilitating factors and barriers to accessibility and utilization of KMC service by the PLBWIs. The identified themes included; availability of KMC providers, social factor (social support and maternal love), timing of KMC information, knowledge on KMC, health linkage systems, recognition of LBWIs, safety on the use of KMC, preference of LBWI’s care practice, lived experience on KMC practice, KMC expert clients, perceived causes of LBWI births, cultural/traditional factors, religious beliefs, health-seeking behavior, women empowerment and quality of care. Conclusions Although KMC was available in some of the health facilities, integration of KMC messages in ANC guidelines, community awareness and in sensitization of any health intervention may enhance KMC accessibility and utilization by the targeted population.

Predictors of Knowledge on Kangaroo Mother Care Practice among Postnatal Mothers with Preterm Babies in Tanzania: A Hospital-Based Cross-Sectional Study

“…The reason of having inadequate knowledge might be due limited information on KMC during ANC as majority of distant health facilities lacked KMC services. This reason was also argued by [39].…”

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

“… 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. Out of the 22 studies, 19 were conducted in the facility 36 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 48 , 49 , 50 , 51 , 52 , 54 , 55 , 56 and three were community-based involving mothers, fathers, grandmothers and traditional birth attendants (TBA). 37 , 47 , 53 A total of 30% of the studies had a sample size of > 13, 60% of the studies had a sample size range of 28–349.…”

“… 37 Compromised quality care because of poor documentation, monitoring, follow-up and inadequate skills by KMC provider barred KMC utilisation by PLBWIs. 51 , 54 …”

“…Lack of women empowerment and their low decision-making power hindered KMC acceptance and utilisation. 36 , 46 , 54 …”

“… 36 Lack of KMC health education at the antenatal clinic and on-going KMC health education by the health workers during the hospital stay hindered mothers to practice KMC. 39 , 43 , 46 , 53 , 54 …”