Barriers for kangaroo mother care (KMC) acceptance, and practices in southern Ethiopia: a model for scaling up uptake and adherence using qualitative study

被引:26
作者
Bilal, Selamawit Mengesha [1 ]
Tadele, Henok [2 ,3 ]
Abebo, Teshome Abuka [1 ]
Tadesse, Birkneh Tilahun [2 ]
Muleta, Mekonnen
Gebriel, Fitsum W. [2 ]
Alemayehu, Akalewold [1 ]
Haji, Yusuf [1 ]
Kassa, Dejene Hailu [1 ]
Astatkie, Ayalew [1 ]
Asefa, Anteneh [1 ]
Teshome, Million [4 ]
Kawza, Aknaw
Wangoro, Shemels [5 ]
Brune, Thomas [6 ]
Singhal, Nalini [7 ]
Worku, Bogale [8 ]
Aziz, Khalid [9 ]
机构
[1] Hawassa Univ, Sch Publ Hlth, Fac Hlth Sci, Coll Med & Hlth Sci, Hawassa, Ethiopia
[2] Hawassa Univ, Fac Med, Coll Med & Hlth Sci, Dept Paediat, Hawassa, Ethiopia
[3] Addis Ababa Univ, Sch Med, Coll Hlth Sci, Dept Pediat & Child Hlth, Addis Ababa, Ethiopia
[4] Hawassa Univ, Fac Med, Coll Med & Hlth Sci, Dept Obstet & Gynaecol, Hawassa, Ethiopia
[5] South Nations & National Reg Hlth Bur, Hawassa, Ethiopia
[6] Sachs Children & Youth Hosp, Stockholm, Sweden
[7] Univ Calgary, Paediat, Calgary, AB, Canada
[8] Addis Ababa Univ, Sch Med, Ethiopian Paediat Soc, Addis Ababa, Ethiopia
[9] Univ Alberta, Paediat, Edmonton, AB, Canada
关键词
Kangaroo mother care; Preterm; Low birth weight; Formative research; Implementation model; Low-income country; PERCEPTIONS; EXPERIENCES; ENABLERS; INFANTS;
D O I
10.1186/s12884-020-03409-6
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
BackgroundGlobally, approximately 15 million babies are born preterm every year. Complications of prematurity are the leading cause of under-five mortality. There is overwhelming evidence from low, middle, and high-income countries supporting kangaroo mother care (KMC) as an effective strategy to prevent mortality in both preterm and low birth weight (LBW) babies. However, implementation and scale-up of KMC remains a challenge, especially in lowincome countries such as Ethiopia. This formative research study, part of a broader KMC implementation project in Southern Ethiopia, aimed to identify the barriers to KMC implementation and to devise a refined model to deliver KMC across the facility to community continuum.MethodsA formative research study was conducted in Southern Ethiopia using a qualitative explorative approach that involved both health service providers and community members. Twenty-fourin-depth interviewsand 14 focus group discussions were carried out with 144study participants. The study applied a grounded theory approach to identify,examine, analyse and extract emerging themes, and subsequently develop a model for KMC implementation.ResultsBarriers to KMC practice included gaps in KMC knowledge, attitude and practices among parents of preterm and LBW babies;socioeconomic, cultural and structural factors; thecommunity's beliefs and valueswith respect to preterm and LBW babies;health professionals' acceptance of KMC as well as their motivation to implement practices; and shortage of supplies in health facilities.ConclusionsOur study suggests a comprehensive approach with systematic interventions and support at maternal, family, community, facility and health care provider levels. We propose an implementation model that addresses this community to facility continuum.
引用
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页数:12
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