Measuring implementation progress in kangaroo mother care

Abstract

Aim: To describe the development and testing of a monitoring model with quantitative indicators or progress markers that could measure the progress of individual hospitals in the implementation of kangaroo mother care (KMC). Methods: Three qualitative data sets in the larger research programme on the implementation of KMC of the MRC Research Unit for Maternal and Infant Health Care Strategies in South Africa were used to develop a progress‐monitoring model and an accompanying instrument. Results: The model was conceptualized around three phases (pre‐implementation, implementation and institutionalization) and six constructs depicting progress (awareness, adopting the concept, mobilization of resources, evidence of practice, evidence of routine and integration, sustainable practice). For each construct, indicators were developed for which data could be collected by means of the monitoring instrument used in a walk‐through visit to a hospital. The instrument has been tested in 65 hospitals. Conclusion: The progress‐monitoring model enables the quantification of individual hospitals' progress in the process of implementing KMC and an objective measurement of the effectiveness of different outreach strategies. The model also has potential to be adapted for measuring progress in other innovative healthcare interventions on a large scale.

Utility of kangaroo mother care in preterm and low birthweight infants

“…South Africa has multiple KMC sites in almost every province, and has employed a low-cost KMC model for lower levels in the health system. 42,66 In most African countries, there are few KMC units, if any, and these are mainly in capital cities. A few countries, notably Malawi, Tanzania and Ghana, now have plans in place to expand KMC to district hospital, or even health centre, level.…”

“…66 This scale was used to compare different implementation strategies, including provision of a standard implementation package with, and without, visits, from a facilitator 68 and onsite, versus off-site, facilitation. 69…”

The presence of physician champions improved Kangaroo Mother Care in rural western India

“…Our work and the extant literature suggest that KMC practices can be increased by recruiting or training physician champions. Experiences from other sites suggest that KMC implementation efforts that use teams of physicians, nurses, psychologists and nutritionists result in sustained KMC practices . Despite this, no objective assessment has been reported in the literature.…”

“…A KMC champion or opinion leader is a health worker who is active in training sessions and enthusiastically encourages mothers to initiate KMC . We used evaluation reports from the head of the NICU and the nurse manager to identify two physicians on the NICU staff who made major contributions to KMC practices during the study period.…”

“…A group of KMC implementation scientists has recommended the use of physician champions to improve KMC practices . A systematic review found that health care providers play an instrumental role in overcoming barriers faced by neonates' parents and health care colleagues for providing KMC .…”