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Barriers and enablers of kangaroo mother care implementation from a health systems perspective: a systematic review.
Health Policy Plan. 2017 Dec 01; 32(10):1466-1475.HP

Abstract

Kangaroo Mother Care (KMC) is an evidence-based intervention that reduces neonatal morbidity and mortality. However, adoption among health systems has varied. Understanding the interaction between health system functions-leadership, financing, healthcare workers (HCWs), technologies, information and research, and service delivery-and KMC is essential to understanding KMC adoption. We present a systematic review of the barriers and enablers of KMC implementation from the perspective of health systems, with a focus on HCWs and health facilities. Using the search terms 'kangaroo mother care', 'skin to skin (STS) care' and 'kangaroo care', we searched Embase, Scopus, Web of Science, Pubmed, and World Health Organization Regional Databases. Reports and hand searched references from publications were also included. Screening and data abstraction were conducted by two independent reviewers using standardized forms. A conceptual model to assess KMC adoption themes was developed using NVivo software. Our search strategy yielded 2875 studies. We included 86 studies with qualitative data on KMC implementation from the perspective of HCWs and/or facilities. Six themes emerged on barriers and enablers to KMC adoption: buy-in and bonding; social support; time; medical concerns; training; and cultural norms. Analysis of interactions between HCWs and facilities yielded further barriers and enablers in the areas of training, communication, and support. HCWs and health facilities serve as two important adopters of Kangaroo Mother Care within a health system. The complex components of KMC lead to multifaceted barriers and enablers to integration, which inform facility, regional, and country-level recommendations for increasing adoption. Further research of methods to promote context-specific adoption of KMC at the health systems level is needed.

Authors+Show Affiliations

Medicine Critical Care, Boston Children's Hospital, Boston, MA, USA. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.Medicine Critical Care, Boston Children's Hospital, Boston, MA, USA.Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.Saving Newborn Lives, Save the Children, Washington, DC, USA.

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

28973515

Citation

Chan, Grace, et al. "Barriers and Enablers of Kangaroo Mother Care Implementation From a Health Systems Perspective: a Systematic Review." Health Policy and Planning, vol. 32, no. 10, 2017, pp. 1466-1475.
Chan G, Bergelson I, Smith ER, et al. Barriers and enablers of kangaroo mother care implementation from a health systems perspective: a systematic review. Health Policy Plan. 2017;32(10):1466-1475.
Chan, G., Bergelson, I., Smith, E. R., Skotnes, T., & Wall, S. (2017). Barriers and enablers of kangaroo mother care implementation from a health systems perspective: a systematic review. Health Policy and Planning, 32(10), 1466-1475. https://doi.org/10.1093/heapol/czx098
Chan G, et al. Barriers and Enablers of Kangaroo Mother Care Implementation From a Health Systems Perspective: a Systematic Review. Health Policy Plan. 2017 Dec 1;32(10):1466-1475. PubMed PMID: 28973515.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Barriers and enablers of kangaroo mother care implementation from a health systems perspective: a systematic review. AU - Chan,Grace, AU - Bergelson,Ilana, AU - Smith,Emily R, AU - Skotnes,Tobi, AU - Wall,Stephen, PY - 2017/07/21/accepted PY - 2017/10/4/pubmed PY - 2018/7/26/medline PY - 2017/10/4/entrez KW - Health systems KW - health facilities KW - health professionals SP - 1466 EP - 1475 JF - Health policy and planning JO - Health Policy Plan VL - 32 IS - 10 N2 - Kangaroo Mother Care (KMC) is an evidence-based intervention that reduces neonatal morbidity and mortality. However, adoption among health systems has varied. Understanding the interaction between health system functions-leadership, financing, healthcare workers (HCWs), technologies, information and research, and service delivery-and KMC is essential to understanding KMC adoption. We present a systematic review of the barriers and enablers of KMC implementation from the perspective of health systems, with a focus on HCWs and health facilities. Using the search terms 'kangaroo mother care', 'skin to skin (STS) care' and 'kangaroo care', we searched Embase, Scopus, Web of Science, Pubmed, and World Health Organization Regional Databases. Reports and hand searched references from publications were also included. Screening and data abstraction were conducted by two independent reviewers using standardized forms. A conceptual model to assess KMC adoption themes was developed using NVivo software. Our search strategy yielded 2875 studies. We included 86 studies with qualitative data on KMC implementation from the perspective of HCWs and/or facilities. Six themes emerged on barriers and enablers to KMC adoption: buy-in and bonding; social support; time; medical concerns; training; and cultural norms. Analysis of interactions between HCWs and facilities yielded further barriers and enablers in the areas of training, communication, and support. HCWs and health facilities serve as two important adopters of Kangaroo Mother Care within a health system. The complex components of KMC lead to multifaceted barriers and enablers to integration, which inform facility, regional, and country-level recommendations for increasing adoption. Further research of methods to promote context-specific adoption of KMC at the health systems level is needed. SN - 1460-2237 UR - https://www.unboundmedicine.com/medline/citation/28973515/Barriers_and_enablers_of_kangaroo_mother_care_implementation_from_a_health_systems_perspective:_a_systematic_review_ L2 - https://academic.oup.com/heapol/article-lookup/doi/10.1093/heapol/czx098 DB - PRIME DP - Unbound Medicine ER -