Enhancing Kangaroo Mother Care Uptake Through Implementation of an Education Protocol
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ORIGINAL ARTICLE
Enhancing Kangaroo Mother Care Uptake Through Implementation of an Education Protocol Rohit Kapoor 1 & Anjali Verma 1 & Poonam Dalal 1 & Geeta Gathwala 1 & Jagjit Dalal 2 Received: 24 June 2020 / Accepted: 7 October 2020 # Dr. K C Chaudhuri Foundation 2020
Abstract Objectives Kangaroo mother care (KMC) uptake is low despite KMC being an evidence based tool to decrease neonatal mortality. It is important that local strategies be developed to enhance KMC usage. This study aimed to assess the effect of implementing an education protocol on the usage of KMC in the NICU and at home after discharge. Methods Preterm mother-infant dyads admitted to the NICU were enrolled prospectively. In initial 3 mo, baseline data on KMC usage in the unit and at home after discharge was collected. In the next three months, a KMC education protocol consisting of one-to-one counseling, education and sensitization of the mother and family members regarding benefits and procedure of KMC and focussed group discussions was implemented such that it became a unit work protocol. In the next 3 mo, data on KMC usage in the unit and at home after discharge was again collected and compared with the baseline data. Results Implementation of the education protocol resulted in earlier initiation of KMC (2.49 ± 0.67 vs. 4.65 ± 0.99 d, p < 0.05); increased duration of KMC (8 h/d vs. 3 h/d, p < 0.05); a higher proportion of eligible preterms receiving KMC during hospital stay (100% vs. 75%, p < 0.05) and at home (87% vs. 28%, p < 0.05) and KMC being provided more often by other family members (27.1% vs. 5.7%, p < 0.05). Conclusions Implementation of a KMC education protocol resulted in improved KMC usage in the unit and at home 4 wk after discharge. Keywords Preterm neonate . Kangaroo mother care uptake . Exclusive breastfeeding . Implementation . Education protocol
Introduction Kangaroo mother care (KMC) is an evidence based costeffective approach to reducing mortality and morbidity in preterm infants [1, 2]. In addition, it has been reported to have other benefits including healthy growth, improved mother infant bonding and long term development [3–5]. However despite all its known benefits, the adoption and implementation of KMC has been wanting. Even in facilities where KMC is practiced, the duration of KMC remains low in our country with a reported average duration of 3–5 h per day [6, 7]. One of the top global research priorities identified by the World
Health Organisation (WHO) for newborn health was how to scale up facility initiated KMC and continuing it at home [8]. There is enough evidence on ways to increase the implementation of KMC but most of this is from outside India. It is a felt need to develop local strategies to enhance the usage of KMC in the Indian context [9]. Lack of knowledge, inadequate family support and absence of formal counseling have been identified as important barriers of KMC in the Indian context [10, 11]. The authors therefore designed a comprehensive KMC education protocol primarily consisting of one
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