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Barriers and facilitators to kangaroo mother care implementation in Cote d'Ivoire: a qualitative study.
BMC Health Serv Res. 2021 Nov 09; 21(1):1211.BH

Abstract

BACKGROUND

Kangaroo Mother Care (KMC) is a high impact, low technology and cost-effective intervention for the care of preterm and low birth weight newborn. Cote d'Ivoire adopted the intervention and opened the first KMC unit in 2019. This study aimed to assess barriers and facilitators of KMC implementation in Cote d'Ivoire, a year after its introduction, as well as proposed solutions for improving KMC implementation in the country.

METHOD

This was a qualitative study, using semi-structured interviews, carried out in September 2020 in the first KMC unit opened at the Teaching Hospital of Treichville. The study involved healthcare providers providing KMC and mothers of newborn who were receiving or received KMC at the unit. A thematic analysis was performed using both inductive and deductive (Consolidated Framework for Implementation Research-driven) approaches. NVivo 12 was used to assist with coding.

RESULTS

A total of 44 semi-structured interviews were conducted, 12 with healthcare providers and 32 with mothers. The barriers identified were lack of supplies, insufficiency of human resources, lack of space for admission, lack of home visits, lack of food for mothers, lack of collaboration between health services involved in newborn care, increased workload, the beliefs of carrying the baby on the chest, father's resistance, low rate of exclusive breastfeeding, lack of community awareness. Facilitators identified were training of healthcare providers, strong leadership, the low cost of KMC, healthcare providers' perceived value of KMC, mothers-healthcare providers' relationship, mothers' adherence to KMC and the capacity of the KMC unit to network with external organizations. The proposed solutions for improving KMC implementation were volunteer staff motivation, intensifying education and counselling of mothers and families, the recruitment of a psychologist and the involvement of all stakeholders.

CONCLUSION

Our study highlighted the challenges to implement KMC in Cote d'Ivoire with unique and specific barriers to implementation. We recommend to researchers and decision makers to respectively design strategies and adopt intervention that specifically address these barriers and facilitators to a better uptake of KMC. Decision makers should also take into account the proposed solutions for a better implementation and scaling up of KMC.

Authors+Show Affiliations

Cellule de Recherche en Santé de la Reproduction, Institut National de Santé Publique, Abidjan, Côte d'Ivoire. kkouroum@gmail.com.Cellule de Recherche en Santé de la Reproduction, Institut National de Santé Publique, Abidjan, Côte d'Ivoire.Cellule de Recherche en Santé de la Reproduction, Institut National de Santé Publique, Abidjan, Côte d'Ivoire.Service de Pédiatrie, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire.Service de Pédiatrie, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire.Service de Pédiatrie, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire.Cellule de Recherche en Santé de la Reproduction, Institut National de Santé Publique, Abidjan, Côte d'Ivoire.United Nation Children's fund (UNICEF) Cote d'Ivoire, Abidjan, Côte d'Ivoire.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34753464

Citation

Kourouma, Kadidiatou Raïssa, et al. "Barriers and Facilitators to Kangaroo Mother Care Implementation in Cote d'Ivoire: a Qualitative Study." BMC Health Services Research, vol. 21, no. 1, 2021, p. 1211.
Kourouma KR, Agbré-Yacé ML, Doukouré D, et al. Barriers and facilitators to kangaroo mother care implementation in Cote d'Ivoire: a qualitative study. BMC Health Serv Res. 2021;21(1):1211.
Kourouma, K. R., Agbré-Yacé, M. L., Doukouré, D., Cissé, L., Some-Méazieu, C., Ouattara, J., Tano-Kamelan, A., & Konan Kouakou, V. (2021). Barriers and facilitators to kangaroo mother care implementation in Cote d'Ivoire: a qualitative study. BMC Health Services Research, 21(1), 1211. https://doi.org/10.1186/s12913-021-07086-9
Kourouma KR, et al. Barriers and Facilitators to Kangaroo Mother Care Implementation in Cote d'Ivoire: a Qualitative Study. BMC Health Serv Res. 2021 Nov 9;21(1):1211. PubMed PMID: 34753464.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Barriers and facilitators to kangaroo mother care implementation in Cote d'Ivoire: a qualitative study. AU - Kourouma,Kadidiatou Raïssa, AU - Agbré-Yacé,Marie Laurette, AU - Doukouré,Daouda, AU - Cissé,Lassina, AU - Some-Méazieu,Chantière, AU - Ouattara,Joseph, AU - Tano-Kamelan,Akoua, AU - Konan Kouakou,Virginie, Y1 - 2021/11/09/ PY - 2021/04/29/received PY - 2021/09/20/accepted PY - 2021/11/10/entrez PY - 2021/11/11/pubmed PY - 2021/11/12/medline KW - Barriers KW - Facilitators KW - Health system KW - Healthcare providers KW - Kangaroo mother care KW - Mothers SP - 1211 EP - 1211 JF - BMC health services research JO - BMC Health Serv Res VL - 21 IS - 1 N2 - BACKGROUND: Kangaroo Mother Care (KMC) is a high impact, low technology and cost-effective intervention for the care of preterm and low birth weight newborn. Cote d'Ivoire adopted the intervention and opened the first KMC unit in 2019. This study aimed to assess barriers and facilitators of KMC implementation in Cote d'Ivoire, a year after its introduction, as well as proposed solutions for improving KMC implementation in the country. METHOD: This was a qualitative study, using semi-structured interviews, carried out in September 2020 in the first KMC unit opened at the Teaching Hospital of Treichville. The study involved healthcare providers providing KMC and mothers of newborn who were receiving or received KMC at the unit. A thematic analysis was performed using both inductive and deductive (Consolidated Framework for Implementation Research-driven) approaches. NVivo 12 was used to assist with coding. RESULTS: A total of 44 semi-structured interviews were conducted, 12 with healthcare providers and 32 with mothers. The barriers identified were lack of supplies, insufficiency of human resources, lack of space for admission, lack of home visits, lack of food for mothers, lack of collaboration between health services involved in newborn care, increased workload, the beliefs of carrying the baby on the chest, father's resistance, low rate of exclusive breastfeeding, lack of community awareness. Facilitators identified were training of healthcare providers, strong leadership, the low cost of KMC, healthcare providers' perceived value of KMC, mothers-healthcare providers' relationship, mothers' adherence to KMC and the capacity of the KMC unit to network with external organizations. The proposed solutions for improving KMC implementation were volunteer staff motivation, intensifying education and counselling of mothers and families, the recruitment of a psychologist and the involvement of all stakeholders. CONCLUSION: Our study highlighted the challenges to implement KMC in Cote d'Ivoire with unique and specific barriers to implementation. We recommend to researchers and decision makers to respectively design strategies and adopt intervention that specifically address these barriers and facilitators to a better uptake of KMC. Decision makers should also take into account the proposed solutions for a better implementation and scaling up of KMC. SN - 1472-6963 UR - https://www.unboundmedicine.com/medline/citation/34753464/Barriers_and_facilitators_to_kangaroo_mother_care_implementation_in_Cote_d'Ivoire:_a_qualitative_study_ DB - PRIME DP - Unbound Medicine ER -