Kangaroo mother care: a systematic review of barriers and enablers

Abstract

ObjectiveTo investigate factors influencing the adoption of kangaroo mother care in different contexts. MethodsWe searched PubMed, Embase, Scopus, Web of Science and the World Health Organization’s regional databases, for studies on “kangaroo mother care” or “kangaroo care” or “skin-to-skin care” from 1 January 1960 to 19 August 2015, without language restrictions. We included programmatic reports and hand-searched references of published reviews and articles. Two independent reviewers screened articles and extracted data on carers, health system characteristics and contextual factors. We developed a conceptual model to analyse the integration of kangaroo mother care in health systems.FindingsWe screened 2875 studies and included 112 studies that contained qualitative data on implementation. Kangaroo mother care was applied in different ways in different contexts. The studies show that there are several barriers to implementing kangaroo mother care, including the need for time, social support, medical care and family acceptance. Barriers within health systems included organization, financing and service delivery. In the broad context, cultural norms influenced perceptions and the success of adoption.ConclusionKangaroo mother care is a complex intervention that is behaviour driven and includes multiple elements. Success of implementation requires high user engagement and stakeholder involvement. Future research includes designing and testing models of specific interventions to improve uptake.

Neonatal intensive care nurses’ knowledge and beliefs regarding kangaroo care in China: a national survey

“…The systematic review by Seidman et al 25 proposed that resource-related barriers (eg, lack of guidelines/education) and sociocultural barriers (eg, concerns about medical conditions/care) negatively affected nurses; our study supports these points. Furthermore, other studies also proposed that lack of knowledge and skills were main barriers to KC implementation,23 26–29 as well as medical staff reluctance to allow KC 10 28–30. Resistance of medical staff is mainly associated with fear of harming infants and lack of experience and specific education in KC.…”

“…WHO reports an average preterm birth rate of 7.1% in China, which makes the country second to India in the highest number of preterm births (ie, >250 000 in 2010) 10. In 2016, Gregson  et al 11 reported that KC is not well known in China; however, with assistance from an international charity, UK midwives have helped promote KC in China.…”

Kangaroo mother care for clinically unstable neonates weighing ≤2000 g: Is it feasible at a hospital in Uganda?

“…Importantly, however, we continuously observed clinical care and KMC practice from the time of enrolment to discharge, up to a maximum of 14 days. In a recent systematic review, only 12% of included studies reported the duration of KMC [79]. For the acceptability sub-study, we interviewed 10 parents (8 mothers and 2 fathers) and 10 providers who had experienced a preterm birth or cared for preterm neonates, respectively.…”

Belief and Policy Influencing Nurses in Implementing Kangaroo Mother Care: A Systematic Review

“…KMC for low birth weight newborns in community settings may greatly improve survival, especially where access to health facilities is limited. In low birth weight newborns (< 2000 g) who are clinically stable, kangaroo mother care reduces mortality and if widely applied could reduce deaths in preterm newborns (Chan et al 2016). Research from various countries also suggests that KMC is a cost-effective method for treating preterm infants, mothers who have practiced KMC may find it acceptable .…”

“…However, in spite of the evidence, country-level adoption and implementation of kangaroo mother care have been limited and global coverage remains low (Chan et al 2016).…”