Perceived Enablers and Barriers of Kangaroo Mother Care among Mothers and Nurses in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Qualitative Study

Document Type : Original Article

Authors

1 Department of Nursing, College of Medical and Health Sciences, Samara University, Afar- Ethiopia

2 School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia

Abstract

Background: Kangaroo mother care is essential improves outcomes of premature and low birth weight infants. Even though kangaroo mother care is now recognized by global experts as an integral part of essential newborn care, the adoption and implementation of the kangaroo mother care is still challenging. Aim of this study to explore perceived enablers and barriers of kangaroo mother care among mothers and nurses in neonatal intensive care unit.
Methods: Descriptive Phenomenological study design was conducted in Tikur Anbessa Specialized referral Hospital at Addis Ababa with 13 mothers and 7 nurses from 10th May -15th July, 2020. In-depth interview used with semi-structured questionnaire and data was collected till saturation of information. Thematic analysis was done with ATLAS.Ti software version 7.5.16 .
Results: Major enablers and barriers of practicing kangaroo mother care among mothers and nurses reported that lack of understanding of KMC, family responsibility and workload, lack of awareness of KMC by community, social practice and traditional adaptation were the barriers to practice of KMC. Poor supervision and follow-up, limited resource especially sanitation resource are the major barriers related to health staff and setting. Nurses reported that scale- up of kangaroo mother care was influenced by absence of training, poor attention given by managers and administrative, shortage of rooms and facilities, workload and time shortage.
Conclusion: A complex array of barriers and enablers determine a mother’s and nurses ability to provide KMC. Improve the mothers' to practice KMC and to promote the health of preterm infants, supports such as family, community and health professional support needed. Nurses needed in-service education, proper administration and less workload to promote KMC practice.
 
 

Keywords


  1. World Health Organization: Recommendations on interventions to improve preterm birth outcomes: Geneva, Switzerland2015.http://apps.who.int/iris/
    handle/10665/183037. Accessed September 3, 2015.
  2. Save The Children MCHIP Jhpiego: Kangaroo Mother Care Implementation Guide Washington, D.C., USA: April 2012.
  3. Opara PI, Okorie EMC. Kangaroo mother care: Mothers experiences post discharge from hospital. J Preg Neonatal Med 2017;1(1): 1-5.
  4. Ministry of Health. (2015). Ethiopian National Health Care Quality Strategy 2016-2020. www. org/et-policies-others/ethiopian-national-health-care-quality- strategy2016-2020/ preview.
  5. Cattaneo A, Amani A, Charpak N, Leon-mendoza S De, Moxon S, Nimbalkar S, et al. Report on an international workshop on kangaroo mother care : lessons learned and a vision for the future. BMC Pregnancy Childbirth. 2018; 18: 170.
  6. Sudell J., Lanlehin R.M., Hill M.C. A literature review of parents’ experiences of kangaroo care in the neonatal unit. Infant 2015; 11(3): 96-99.
  7. Chan G, Labar A, Wall S, Atun R. Kangaroo mother care: A systematic review of barriers and enablers. Bull World Health Organ. 2016; 94 (2):130J-141J.
  8. Smith E, Bergelson I, Constantian S, Valsangkar B, Chan G. Barriers and enablers of health system adoption of kangaroo mother care: A systematic review of caregiver perspectives. BMC Pediatr. 2017; 17 (1):1–16. Available from: http://dx.
    org/10.1186/s12887-016-0769-5.
  9. Jamali Q, Shah R, Shahid F, Fatima A, Khalsa S, Spacek J, et al. Barriers and enablers for practicing kangaroo mother care (KMC) in rural Sindh, Pakistan. PLoS One. 2019; 14 (6):1–15.
  10. Debi F, Linda H, Barriers to skin to skin care during the postpartum stay. 2014; 39(1). DOI: 1097/
    01.NMC.0000437464.31628.3d 27.
  11. Silva LJ, Leite JL, Silva TP, Silva IR, Mourão PP, Gomes TM. Management challenges for best practices of the Kangaroo Method in the Neonatal ICU. Rev Bras Enferm [Internet]. 2018;71 (Suppl 6):2783-91. [Thematic Issue: Good practices in the care process as the centrality of the Nursing] DOI: http://dx.doi.org/10.1590/0034-7167-2018-0428.
  12. Alenchery AJ, Thoppil J, Britto CD, de Onis JV, Fernandez L, Suman Rao PN. Barriers and enablers to skin-to-skin contact at birth in healthy neonates - a qualitative study. BMC Pediatr. 2018;18(1).