The three waves in implementation of facility-based kangaroo mother care: a multi-country case study from Asia
| Autor: | Rekha H. Udani, Alyssa Om’Iniabohs, Joseph de Graft-Johnson, Anne Marie Bergh, Neena Khadka, Socorro De Leon-Mendoza, Hadi Pratomo |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Maternal-Child Health Services Institutionalisation Philippines Population Developing country India Global Health 03 medical and health sciences 0302 clinical medicine Nursing Pregnancy 030225 pediatrics Health care Infant Mortality Global health medicine Humans Delivery of health care 030212 general & internal medicine Newborn health education Developing Countries Neonatal mortality education.field_of_study business.industry Public health Public Health Environmental and Occupational Health Health Plan Implementation Infant Newborn Infant Infant Low Birth Weight Infant premature Infant mortality Kangaroo-Mother Care Method Intervention (law) Indonesia Implementation Female business Infant Premature Kangaroo mother care Research Article |
| Zdroj: | BMC International Health and Human Rights |
| ISSN: | 1472-698X |
| Popis: | Background: Kangaroo mother care has been highlighted as an effective intervention package to address high neonatal mortality pertaining to preterm births and low birth weight. However, KMC uptake and service coverage have not progressed well in many countries. The aim of this case study was to understand the institutionalisation processes of facility-based KMC services in three Asian countries (India, Indonesia and the Philippines) and the reasons for the slow uptake of KMC in these countries. Methods: Three main data sources were available: background documents providing insight in the state of implementation of KMC in the three countries; visits to a selection of health facilities to gauge their progress with KMC implementation; and data from interviews and meetings with key stakeholders. Results: The establishment of KMC services at individual facilities began many years before official prioritisation for scale-up. Three major themes were identified: pioneers of facility-based KMC; patterns of KMC knowledge and skills dissemination; and uptake and expansion of KMC services in relation to global trends and national policies. Pioneers of facility-based KMC were introduced to the concept in the 1990s and established the practice in a few individual tertiary or teaching hospitals, without further spread. A training method beneficial to the initial establishment of KMC services in a country was to send institutional health-professional teams to learn abroad, notably in Colombia. Further in-country cascading took place afterwards and still later on KMC was integrated into newborn and obstetric care programs. The patchy uptake and expansion of KMC services took place in three phases aligned with global trends of the time: the pioneer phase with individual champions while the global focus was on child survival (1998–2006); the newborn-care phase (2007–2012); and lastly the current phase where small babies are also included in action plans. Conclusions: This paper illustrates the complexities of implementing a new healthcare intervention. Although preterm care is currently in the limelight, clear and concerted country-led KMC scale-up strategies with associated operational plans and budgets are essential for successful scale-up. |
| Databáze: | OpenAIRE |
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