Introducing home based skin-to-skin care for low birth weight newborns: a pilot approach to education and counseling in Ghana

Bazzano, Alessandra N.; Hill, Zelee; Tawiah-Agyemang, Charlotte; Manu, Alexander; Asbroek, Guus ten; Kirkwood, Betty

doi:10.1177/1757975912453185

Cited by 26 publications

(69 citation statements)

References 13 publications

(20 reference statements)

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“…In this study most mothers were willing and some had even tried it, but the major challenge to skin-to-skin care is the lack of continuity. In Ghana, mothers reported that backache, time constraints, fear to harm the cord were barriers to skin-to-skin care and the practice was cautiously adopted [22]. In this study, mothers that delivered in the hospital were told about KMC, although it was not demonstrated in all the cases except for babies who spent some days in the KMC room, where health workers showed the mothers how to correctly tie the baby in the mother’s chest.…”

Section: Discussionmentioning

confidence: 99%

Recognition and home care of low birth weight neonates: a qualitative study of knowledge, beliefs and practices of mothers in Iganga-Mayuge Health and Demographic Surveillance Site, Uganda

et al. 2014

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BackgroundNeonatal mortality has remained persistently high worldwide. In Uganda, neonatal deaths account for 50% of all infant deaths. Low birth weight is associated with a higher risk of death during the neonatal period. Failure to recognize low birth weight and inappropriate home care practices increase the risk of morbidity and mortality in this high risk group. This study explored mothers’ knowledge, beliefs and practices in recognising and providing home care for low birth weight babies.MethodsThe study was carried out in Eastern Uganda. In-depth interviews were conducted with sixteen mothers of small babies who delivered in health facilities (10) or at home (6) two months prior to the study. Interviews were conducted in mothers’ homes using the local language. Interviewer notes and audio recordings were transcribed and translated to English. Content analysis was done using Atlas-ti software.ResultsRecognition of low birth weight by mothers when a baby is not weighed was difficult. Mothers were aware of the causes of low birth weight though some mothers believed in the influence of supernatural powers. Mothers who delivered in hospital had better knowledge of appropriate home care practices for low birth weight babies compared to mothers who delivered at home or in a lower level health facility. Practices related to cord care and keeping the baby warm were good while poor practices were noted concerning initiation and exclusive breast feeding, and bathing the baby. Low birth weight was not appreciated as a danger sign in newborns and therefore mothers did not seek health care. Some mothers who initiated good care practices for low birth weight newborns in the facilities did not sustain them at home.ConclusionsRecognition of low birth weight is still poor. This leads to inappropriate home care practices for these high risk newborns. Mothers’ knowledge and care practices can be improved through health education, and this should be extended to the community to reach mothers that deliver at home. Mechanisms to support mothers to sustain good practices should be put in place by taking advantage of existing village health teams and social support.

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Section: Discussionmentioning

confidence: 99%

Recognition and home care of low birth weight neonates: a qualitative study of knowledge, beliefs and practices of mothers in Iganga-Mayuge Health and Demographic Surveillance Site, Uganda

et al. 2014

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“…While concerns with postpartum confinement is a cultural barrier to KMC implementation in specific countries, most studies have identified some socio-cultural barriers specific to their context or country. For example, carrying babies on the back instead of the front is commonly reported as a barrier in many countries, and early bathing behaviors are common in Ghana and Bangladesh, both making KMC adoption difficult [17,18]. Addressing these cultural barriers requires an understanding of health promotion and social mobilization specific to these local settings.…”

Section: Barriers and Facilitators At Cultural Levelmentioning

confidence: 99%

“…Medical staff should look out for warning signs and offer support to parents by introducing them to peer support groups. Some parents were unable to provide KMC or could not continue with it for a long time due to the pain, fatigue, complications and other physical factors [17,18,21,28]. Therefore providing comfortable chairs and environment for mothers could encourage them to practice KMC for longer duration.…”

Section: Barriers and Facilitators At Parental Levelmentioning

confidence: 99%

Barriers and Facilitators of Kangaroo Mother Care Adoption in Five Chinese Hospitals: a Qualitative Study

Yue

Williams³

et al. 2020

Preprint

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Background Kangaroo mother care (KMC) has been proved to be a safe and cost-effective intervention for preterm babies. Despite this evidence and global guidelines promoting KMC, it has not been widely adopted in China. In this study, we aim to assess barriers and facilitators of KMC adoption in neonatal intensive care units (NICUs) and postnatal wards in China. Methods We conducted clinical observation and semi-structured interviews in seven NICUs and postnatal wards housed in five hospitals from different provinces in China between August and September 2018. We conducted interviews with pediatricians, obstetricians, nurses and parents who performed KMC to understand their perspectives on barriers and facilitators of KMC implementation and sustainability. We further explored health system’s readiness and families’ willingness to adopt KMC following its introduction in pilot hospitals. We coded data for emerging themes related to perceived barriers and facilitators of KMC adoption, specifically those unique in the Chinese context and less commonly reported in previous systematic reviews from other countries. Results Five hospitals were included for clinical observation and 38 semi-structured interviews were conducted. Common cultural barriers included concerns with postpartum confinement (Zuo-yue-zi) and grandparents’ resistance, while strong family support enabled KMC adoption. Parents may feel anxious and guilty about having a preterm baby, this is a parental-level barrier to KMC. Hospital-level factors such as fear of nosocomial infection and shortage of staff and spaces impeded KMC implementation, and hospital-led supportive community and peer group contributed to KMC uptake. Financial barriers included lodging costs for caregivers and supply costs for hospitals. Conclusions Barriers and facilitators exist across cultural, hospital, parental and financial levels. While several factors were common in other study settings, there are also barriers and facilitators unique to Chinese context, e.g. concerns with postpartum confinement (Zuo-yue-zi), grandparents’ resistance and staff’s fear of nosocomial infection. We recommend interventions specificially targeting these barriers and facilitators including family and peer support for improved KMC adoption in China. We also recommend that specific barriers and challenges to KMC in particular settings be identified and be taken into account prior to KMC uptake in other settings.

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“…According to several published studies, the interference of KMC in the mother's daily work schedule is a frequently reported barrier. [4,[11][12][13] It is noteceable that this study was conducted in a rural area of Rwanda. This is also visible through the reported profession, 89.5% said to be farmer, cultivator or planter.…”

Section: Discussionmentioning

confidence: 99%

Kangaroo mother care in the community: practices in southern Rwanda

Nyagasare¹,

Cauwelier²,

Mwali³

et al. 2020

Rwanda Journal of Medicine and Health Sciences

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Background The World Health Organization (WHO) guidelines recommend practicing KMC (Kangaroo Mother Care) continuously for weeks after discharge of preterm newborns. However, little is known about KMC practices in the community in Rwanda and other African countries.Therefore, this study sought to assess KMC practices in Southern Rwanda, primarily after hospitalization and identify barriers to KMC in the community. Methods A cross-sectional study was performed with data collected through a survey among 124 caregivers of preterm infants and Community Health Workers. The Statistical Package for the Social Sciences SPSS version 22 was used to analyze the data. Results Among all caregivers interviewed, 86.7% confirmed that they practiced KMC, both in the hospital (KABUTARE District Hospital) as well as after discharge, but there is a large variation in practice time and place. KMC is practiced more during daytime. Working in the fields and lack of support to the caregivers are reported most frequently as barriers to practice KMC in the community. Conclusion KMC-practice is still sub-optimal in Rwanda. Special attention should be directed towards KMCpractice at night and towards the reported obstacles of practicing KMC in the community, e.g. working in the field, lack of support and equipment, difficulties to sleep and health problems.

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Introducing home based skin-to-skin care for low birth weight newborns: a pilot approach to education and counseling in Ghana

Abstract: Some study participants tried STSC but none did it continuously. As promotion of STSC could be vital for improving newborn survival in low resource settings, tackling perceived barriers may be an important way to increase acceptability of this practice.

Cited by 26 publications

References 13 publications

Recognition and home care of low birth weight neonates: a qualitative study of knowledge, beliefs and practices of mothers in Iganga-Mayuge Health and Demographic Surveillance Site, Uganda

Recognition and home care of low birth weight neonates: a qualitative study of knowledge, beliefs and practices of mothers in Iganga-Mayuge Health and Demographic Surveillance Site, Uganda

Barriers and Facilitators of Kangaroo Mother Care Adoption in Five Chinese Hospitals: a Qualitative Study

Kangaroo mother care in the community: practices in southern Rwanda

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