Scaling up Kangaroo Mother Care in Ethiopia and India: a multi-site implementation research study
| Autor: | Selemawit Asfaw Beyene, Amit Kumar, Khalid Aziz, Hajira Mohammed, Abiy Seifu Estifanos, Arun Singh Jadaun, John N. Cranmer, Thomas Brune, Vishwajeet Kumar, Lynn M. Sibley, Tedros Hailu Abay, Rajiv Bahl, Pankaj Kumar, Jose Martines, Abebe Gebremariam Gobezayehu, Raghav Krishna, Sonia Trikha, Mesfin Kote Debere, Mulusew Lijalem Belew, Birkneh Tilahun Tadesse, Dawit Seyoum Gebremariam, Gary Lee Darmstadt, Lamesgin Alamineh, Addisalem Fikre, Araya Abrha Medhanyie, Harsh Vardhan Jaiswal, Suresh Dalpath, Sarmila Mazumder, Damen Hailemariam, Dereje Duguma, Aarti Kumar, Suman Rao Pn, Tarun Kumar, Anayda Portela, Maryann Washington, Krishnamurthy Jayanna, Henok Tadele, Pramod Kumar Singh, Fisseha Ashebir Gebregizabher, Gebriel, Abraham Tariku, Dejene Hailu Kassa, Fitsum W, Nita Bhandari, Grace J Chan, H L Mohan, Ramesh Agarwal, Selamawit Mengesha Bilal, Prem Mony, Arin Kar, Arti Sahu, Marta Yemane Hadush, Prabhu Deva Gowda, Samson Yohannes Amare |
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| Rok vydání: | 2021 |
| Předmět: |
Medicine (General)
Birth weight Breastfeeding Aftercare India Infectious and parasitic diseases RC109-216 R5-920 Nursing medicine Humans Trial registration business.industry Health Policy Public Health Environmental and Occupational Health Multi site Infant Newborn Kangaroo-Mother Care Patient Discharge Kangaroo-Mother Care Method Low birth weight Female Implementation research Ethiopia medicine.symptom business Formative research |
| Zdroj: | BMJ Global Health, Vol 6, Iss 9 (2021) |
| ISSN: | 2059-7908 |
| Popis: | ObjectivesKangaroo Mother Care (KMC), prolonged skin-to-skin care of the low birth weight baby with the mother plus exclusive breastfeeding reduces neonatal mortality. Global KMC coverage is low. This study was conducted to develop and evaluate context-adapted implementation models to achieve improved coverage.DesignThis study used mixed-methods applying implementation science to develop an adaptable strategy to improve implementation. Formative research informed the initial model which was refined in three iterative cycles. The models included three components: (1) maximising access to KMC-implementing facilities, (2) ensuring KMC initiation and maintenance in facilities and (3) supporting continuation at home postdischarge.Participants3804 infants of birth weight under 2000 g who survived the first 3 days, were available in the study area and whose mother resided in the study area.Main outcome measuresThe primary outcomes were coverage of KMC during the 24 hours prior to discharge and at 7 days postdischarge.ResultsKey barriers and solutions were identified for scaling up KMC. The resulting implementation model achieved high population-based coverage. KMC initiation reached 68%–86% of infants in Ethiopian sites and 87% in Indian sites. At discharge, KMC was provided to 68% of infants in Ethiopia and 55% in India. At 7 days postdischarge, KMC was provided to 53%–65% of infants in all sites, except Oromia (38%) and Karnataka (36%).ConclusionsThis study shows how high coverage of KMC can be achieved using context-adapted models based on implementation science. They were supported by government leadership, health workers’ conviction that KMC is the standard of care, women’s and families’ acceptance of KMC, and changes in infrastructure, policy, skills and practice.Trial registration numbersISRCTN12286667; CTRI/2017/07/008988; NCT03098069; NCT03419416; NCT03506698. |
| Databáze: | OpenAIRE |
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