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Barriers for kangaroo mother care (KMC) acceptance, and practices in southern Ethiopia: a model for scaling up uptake and adherence using qualitative study.
BMC Pregnancy Childbirth. 2021 Jan 07; 21(1):25.BP

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

Authors+Show Affiliations

College of Medicine and Health Sciences, Faculty of Health Sciences, School of Public Health, Hawassa University, Hawassa, Ethiopia. Selamhunu@gmail.com.Department of Paediatrics, College of Medicine and Health Sciences, Faculty of Medicine, Hawassa University, Hawassa, Ethiopia. Department of Pediatrics and Child Health, College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.College of Medicine and Health Sciences, Faculty of Health Sciences, School of Public Health, Hawassa University, Hawassa, Ethiopia.Department of Paediatrics, College of Medicine and Health Sciences, Faculty of Medicine, Hawassa University, Hawassa, Ethiopia.Independent Consultant, Addis Ababa, Ethiopia.Department of Paediatrics, College of Medicine and Health Sciences, Faculty of Medicine, Hawassa University, Hawassa, Ethiopia.College of Medicine and Health Sciences, Faculty of Health Sciences, School of Public Health, Hawassa University, Hawassa, Ethiopia.College of Medicine and Health Sciences, Faculty of Health Sciences, School of Public Health, Hawassa University, Hawassa, Ethiopia.College of Medicine and Health Sciences, Faculty of Health Sciences, School of Public Health, Hawassa University, Hawassa, Ethiopia.College of Medicine and Health Sciences, Faculty of Health Sciences, School of Public Health, Hawassa University, Hawassa, Ethiopia.College of Medicine and Health Sciences, Faculty of Health Sciences, School of Public Health, Hawassa University, Hawassa, Ethiopia.Department of Obstetrics and Gynaecology, College of Medicine and Health Sciences, Faculty of Medicine, Hawassa University, Hawassa, Ethiopia.South Nations and Nationalities Regional Health Bureau Head, Hawassa, Ethiopia.South Nations and Nationalities Regional Health Bureau, Maternal and Child Health Director, Hawassa, Ethiopia.Sachs' Children and Youth Hospital, Stockholm, Sweden.Paediatrics, University of Calgary, Calgary, Canada.School of Medicine, Addis Ababa University, Ethiopian Paediatrics Society, Addis Ababa, Ethiopia.Paediatrics, University of Alberta, Edmonton, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33413193

Citation

Bilal, Selamawit Mengesha, et al. "Barriers for Kangaroo Mother Care (KMC) Acceptance, and Practices in Southern Ethiopia: a Model for Scaling Up Uptake and Adherence Using Qualitative Study." BMC Pregnancy and Childbirth, vol. 21, no. 1, 2021, p. 25.
Bilal SM, Tadele H, Abebo TA, et al. Barriers for kangaroo mother care (KMC) acceptance, and practices in southern Ethiopia: a model for scaling up uptake and adherence using qualitative study. BMC Pregnancy Childbirth. 2021;21(1):25.
Bilal, S. M., Tadele, H., Abebo, T. A., Tadesse, B. T., Muleta, M., W/Gebriel, F., Alemayehu, A., Haji, Y., Kassa, D. H., Astatkie, A., Asefa, A., Teshome, M., Kawza, A., Wangoro, S., Brune, T., Singhal, N., Worku, B., & Aziz, K. (2021). Barriers for kangaroo mother care (KMC) acceptance, and practices in southern Ethiopia: a model for scaling up uptake and adherence using qualitative study. BMC Pregnancy and Childbirth, 21(1), 25. https://doi.org/10.1186/s12884-020-03409-6
Bilal SM, et al. Barriers for Kangaroo Mother Care (KMC) Acceptance, and Practices in Southern Ethiopia: a Model for Scaling Up Uptake and Adherence Using Qualitative Study. BMC Pregnancy Childbirth. 2021 Jan 7;21(1):25. PubMed PMID: 33413193.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Barriers for kangaroo mother care (KMC) acceptance, and practices in southern Ethiopia: a model for scaling up uptake and adherence using qualitative study. AU - Bilal,Selamawit Mengesha, AU - Tadele,Henok, AU - Abebo,Teshome Abuka, AU - Tadesse,Birkneh Tilahun, AU - Muleta,Mekonnen, AU - W/Gebriel,Fitsum, AU - Alemayehu,Akalewold, AU - Haji,Yusuf, AU - Kassa,Dejene Hailu, AU - Astatkie,Ayalew, AU - Asefa,Anteneh, AU - Teshome,Million, AU - Kawza,Aknaw, AU - Wangoro,Shemels, AU - Brune,Thomas, AU - Singhal,Nalini, AU - Worku,Bogale, AU - Aziz,Khalid, Y1 - 2021/01/07/ PY - 2019/08/29/received PY - 2020/11/10/accepted PY - 2021/1/8/entrez PY - 2021/1/9/pubmed PY - 2021/5/18/medline KW - Formative research KW - Implementation model KW - Kangaroo mother care KW - Low birth weight KW - Low-income country KW - Preterm SP - 25 EP - 25 JF - BMC pregnancy and childbirth JO - BMC Pregnancy Childbirth VL - 21 IS - 1 N2 - BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. SN - 1471-2393 UR - https://www.unboundmedicine.com/medline/citation/33413193/Barriers_for_kangaroo_mother_care__KMC__acceptance_and_practices_in_southern_Ethiopia:_a_model_for_scaling_up_uptake_and_adherence_using_qualitative_study_ DB - PRIME DP - Unbound Medicine ER -