Tags

Type your tag names separated by a space and hit enter

Kangaroo mother care: using formative research to design an acceptable community intervention.
BMC Public Health. 2018 03 02; 18(1):307.BP

Abstract

BACKGROUND

Low and middle income countries (LMICs), including India, contribute to a major proportion of low birth weight (LBW) infants globally. These infants require special care. Kangaroo Mother Care (KMC) in hospitals is a cost effective and efficacious intervention. In institutional deliveries, the duration of facility stay is often short. In LMICs, a substantial proportion of deliveries still occur at home and access to health care services is limited. In these circumstances, a pragmatic choice may be to initiate KMC at home for LBW babies. However, evidence is lacking on benefits of community-initiated KMC (cKMC). Promoting KMC at home without an understanding of its acceptability may lead to limited success.

METHODS

We conducted formative research to assess the feasibility, acceptability and adoption of cKMC with the aim of designing an intervention package for a randomised controlled trial in LBW infants in Haryana, India. Qualitative methods included 40 in-depth interviews with recently delivered women and 6 focus group discussions, two each with fathers and grandfathers, grandmothers, and community health workers. A prototype intervention package to promote cKMC was developed and tested in 28 mother-infant pairs (of them, one mother had twins), using Household (HH) trials.

RESULTS

We found that most mothers in the community recognized that babies born small required special care. In spite of not being aware of the practice of KMC, respondents felt that creating awareness of KMC benefits will promote practice. They expressed concerns about doing KMC for long periods because mothers needed rest after delivery. However, the cultural practice of recently delivered women not expected to be doing household chores and availability of other family members were identified as enablers. HH trials provided an opportunity to test the intervention package and showed high acceptability for KMC. Most mothers perceived benefits such as weight gain and increased activity in the infant.

CONCLUSIONS

Community-initiated KMC is acceptable by mothers and adoption rates are high. Formative research is essential for developing a strategy for delivery of an intervention.

TRIAL REGISTRATION

Trial registration number CTRI/2015/10/006267 . Name of Registry: Clinical Trials Registry - India. URL of Registry: http://ctri.nic.in/Clinicaltrials/login.php Date of Registration: 15/10/2015. Date of enrolment of the first participant to the trial: 18/04/2015.

Authors+Show Affiliations

Centre for Health Research and Development, Society for Applied Studies, 45, Kalu Sarai, New Delhi, 110016, India.Centre for Health Research and Development, Society for Applied Studies, 45, Kalu Sarai, New Delhi, 110016, India.Institute for Global Health, Faculty of Population Health Sciences, University College of London, London, UK.Centre for Health Research and Development, Society for Applied Studies, 45, Kalu Sarai, New Delhi, 110016, India.Centre for Health Research and Development, Society for Applied Studies, 45, Kalu Sarai, New Delhi, 110016, India.Centre for Health Research and Development, Society for Applied Studies, 45, Kalu Sarai, New Delhi, 110016, India.Centre for Health Research and Development, Society for Applied Studies, 45, Kalu Sarai, New Delhi, 110016, India.Centre for Health Research and Development, Society for Applied Studies, 45, Kalu Sarai, New Delhi, 110016, India.Centre for Health Research and Development, Society for Applied Studies, 45, Kalu Sarai, New Delhi, 110016, India.Centre for Intervention Science in Maternal and Child Health, Centre for International Health, University of Bergen, Bergen, Norway.Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland.Centre for Intervention Science in Maternal and Child Health, Centre for International Health, University of Bergen, Bergen, Norway.Centre for Health Research and Development, Society for Applied Studies, 45, Kalu Sarai, New Delhi, 110016, India. nita.bhandari@sas.org.in.

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29499685

Citation

Mazumder, Sarmila, et al. "Kangaroo Mother Care: Using Formative Research to Design an Acceptable Community Intervention." BMC Public Health, vol. 18, no. 1, 2018, p. 307.
Mazumder S, Upadhyay RP, Hill Z, et al. Kangaroo mother care: using formative research to design an acceptable community intervention. BMC Public Health. 2018;18(1):307.
Mazumder, S., Upadhyay, R. P., Hill, Z., Taneja, S., Dube, B., Kaur, J., Shekhar, M., Ghosh, R., Bisht, S., Martines, J. C., Bahl, R., Sommerfelt, H., & Bhandari, N. (2018). Kangaroo mother care: using formative research to design an acceptable community intervention. BMC Public Health, 18(1), 307. https://doi.org/10.1186/s12889-018-5197-z
Mazumder S, et al. Kangaroo Mother Care: Using Formative Research to Design an Acceptable Community Intervention. BMC Public Health. 2018 03 2;18(1):307. PubMed PMID: 29499685.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Kangaroo mother care: using formative research to design an acceptable community intervention. AU - Mazumder,Sarmila, AU - Upadhyay,Ravi Prakash, AU - Hill,Zelee, AU - Taneja,Sunita, AU - Dube,Brinda, AU - Kaur,Jasmine, AU - Shekhar,Medha, AU - Ghosh,Runa, AU - Bisht,Shruti, AU - Martines,Jose Carlos, AU - Bahl,Rajiv, AU - Sommerfelt,Halvor, AU - Bhandari,Nita, Y1 - 2018/03/02/ PY - 2017/08/25/received PY - 2018/02/21/accepted PY - 2018/3/4/entrez PY - 2018/3/4/pubmed PY - 2018/6/9/medline KW - Formative research KW - Household trials KW - Kangaroo mother care SP - 307 EP - 307 JF - BMC public health JO - BMC Public Health VL - 18 IS - 1 N2 - BACKGROUND: Low and middle income countries (LMICs), including India, contribute to a major proportion of low birth weight (LBW) infants globally. These infants require special care. Kangaroo Mother Care (KMC) in hospitals is a cost effective and efficacious intervention. In institutional deliveries, the duration of facility stay is often short. In LMICs, a substantial proportion of deliveries still occur at home and access to health care services is limited. In these circumstances, a pragmatic choice may be to initiate KMC at home for LBW babies. However, evidence is lacking on benefits of community-initiated KMC (cKMC). Promoting KMC at home without an understanding of its acceptability may lead to limited success. METHODS: We conducted formative research to assess the feasibility, acceptability and adoption of cKMC with the aim of designing an intervention package for a randomised controlled trial in LBW infants in Haryana, India. Qualitative methods included 40 in-depth interviews with recently delivered women and 6 focus group discussions, two each with fathers and grandfathers, grandmothers, and community health workers. A prototype intervention package to promote cKMC was developed and tested in 28 mother-infant pairs (of them, one mother had twins), using Household (HH) trials. RESULTS: We found that most mothers in the community recognized that babies born small required special care. In spite of not being aware of the practice of KMC, respondents felt that creating awareness of KMC benefits will promote practice. They expressed concerns about doing KMC for long periods because mothers needed rest after delivery. However, the cultural practice of recently delivered women not expected to be doing household chores and availability of other family members were identified as enablers. HH trials provided an opportunity to test the intervention package and showed high acceptability for KMC. Most mothers perceived benefits such as weight gain and increased activity in the infant. CONCLUSIONS: Community-initiated KMC is acceptable by mothers and adoption rates are high. Formative research is essential for developing a strategy for delivery of an intervention. TRIAL REGISTRATION: Trial registration number CTRI/2015/10/006267 . Name of Registry: Clinical Trials Registry - India. URL of Registry: http://ctri.nic.in/Clinicaltrials/login.php Date of Registration: 15/10/2015. Date of enrolment of the first participant to the trial: 18/04/2015. SN - 1471-2458 UR - https://www.unboundmedicine.com/medline/citation/29499685/Kangaroo_mother_care:_using_formative_research_to_design_an_acceptable_community_intervention_ L2 - https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-018-5197-z DB - PRIME DP - Unbound Medicine ER -