Barriers for kangaroo mother care (KMC) acceptance, and practices in southern Ethiopia: a model for scaling up uptake and adherence using qualitative study

• Published in: BMC pregnancy and childbirth Vol. 21; no. 1; p. 25
• Main Authors: Bilal, Selamawit Mengesha, Tadele, Henok, Abebo, Teshome Abuka, Tadesse, Birkneh Tilahun, Muleta, Mekonnen, W/Gebriel, Fitsum, Alemayehu, Akalewold, Haji, Yusuf, Kassa, Dejene Hailu, Astatkie, Ayalew, Asefa, Anteneh, Teshome, Million, Kawza, Aknaw, Wangoro, Shemels, Brune, Thomas, Singhal, Nalini, Worku, Bogale, Aziz, Khalid
• Format: Journal Article
• Language: English
• Published: England BioMed Central 07.01.2021; BMC
• Subjects: Adult; Birth weight; Births; Community; Community Health Workers; Confidentiality; Culture; Data analysis; Data collection; Ethiopia; Families & family life; Family - psychology; Family physicians; Female; Focus Groups; Folkhälsovetenskap, global hälsa och socialmedicin; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi; Formative research; General Practitioners; Grounded Theory; Health facilities; Health Knowledge, Attitudes, Practice; Health services; Home Childbirth - psychology; Humans; Hälsovetenskap; Implementation model; Infant; Infant Mortality; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature; Interviews; Investigations; Kangaroo mother care; Kangaroo-Mother Care Method - psychology; Klinisk medicin; Low birth weight; Low-income country; Medical personnel; Medical referrals; Medicin och hälsovetenskap; Models, Theoretical; Mothers; Omvårdnad; Patient Preference; Pediatricians; Pediatrik; Premature birth; Preterm; Qualitative Research; Referral and Consultation; Skin; Ethiopia; Low-income country; Implementation model; Formative research; Kangaroo mother care; Low birth weight; Preterm
• ISSN: 1471-2393; 1471-2393
• DOI: 10.1186/s12884-020-03409-6

Globally, approximately 15 million babies are born preterm every year. Complications of prematurity are the leading cause of under-five mortality. There is overwhelming evidence from low, middle, and high-income countries supporting kangaroo mother care (KMC) as an effective strategy to prevent mortality in both preterm and low birth weight (LBW) babies. However, implementation and scale-up of KMC remains a challenge, especially in lowincome countries such as Ethiopia. This formative research study, part of a broader KMC implementation project in Southern Ethiopia, aimed to identify the barriers to KMC implementation and to devise a refined model to deliver KMC across the facility to community continuum. A formative research study was conducted in Southern Ethiopia using a qualitative explorative approach that involved both health service providers and community members. Twenty-fourin-depth interviewsand 14 focus group discussions were carried out with 144study participants. The study applied a grounded theory approach to identify,examine, analyse and extract emerging themes, and subsequently develop a model for KMC implementation. Barriers to KMC practice included gaps in KMC knowledge, attitude and practices among parents of preterm and LBW babies;socioeconomic, cultural and structural factors; thecommunity's beliefs and valueswith respect to preterm and LBW babies;health professionals' acceptance of KMC as well as their motivation to implement practices; and shortage of supplies in health facilities. Our study suggests a comprehensive approach with systematic interventions and support at maternal, family, community, facility and health care provider levels. We propose an implementation model that addresses this community to facility continuum.