Determinants of Kangaroo Mother Care Uptake for Small Babies Along the Health Facility to Community Continuum in Karnataka, India

Washington, Maryann; Macaden, Leah; Smith, Annetta; Selvam, Sumithra; Mony, Prem

doi:10.9745/ghsp-d-22-00457

Cited by 3 publications

(1 citation statement)

References 39 publications

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“…KMC implementation in the health care delivery settings and the continuum of KMC practice at home including the duration of community KMC practice (cKMC) (13,14).…”

Section: Discussionmentioning

confidence: 99%

Exploring community Kangaroo Mother Care practices among NICU graduates: a prospective cohort study in South India

Jeganathan,

Schwinger,

Strand

et al. 2023

Preprint

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Aim To describe KMC practice in the community (cKMC) after discharge from the Neonatal Intensive Care Unit (NICU) in South Indian mother-LBW infants. Method A prospective study enrolling 420 dyads at discharge from the NICU with follow-up on cKMC practice two months after discharge. Factors associated with cKMC were explored using logistic regression. Result Among the 420 enrolled, 2 (0.5%) infants died, and 12 (2.9%) were lost to follow-up. Of the remaining families, 25% (101) never practiced cKMC, and effective practice was done by 25% (77). Infant birth weight ≥ 1.5 kg (OR: 3.1, 95% CI 1.8, 5.3) was associated with higher odds of practicing cKMC, while infant born at term (OR: 0.5, 95% CI 0.3, 0.8) and mothers’ weight > 45 kg (OR: 0.3, 95% CI 0.1–0.7) was associated with lower odds of practicing cKMC. Continued KMC practice 48 hours before discharge was associated with higher odds (OR: 3.4, 95% CI 1.8–6.2), while absence of father's support was associated with lower odds (OR: 0.6, 95% CI 0.3, 1.0) of effective cKMC. Conclusion The continuum of cKMC after discharge from the NICU was inadequate. Factors associated with cKMC practice should be considered when planning interventions to improve cKMC practices.

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“…KMC implementation in the health care delivery settings and the continuum of KMC practice at home including the duration of community KMC practice (cKMC) (13,14).…”

Section: Discussionmentioning

confidence: 99%

Exploring community Kangaroo Mother Care practices among NICU graduates: a prospective cohort study in South India

Jeganathan,

Schwinger,

Strand

et al. 2023

Preprint

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Kangaroo Mother Care Practices in Tertiary Care NICUs Across India: A Cross-sectional Questionnaire-based Survey

Rao Kodhati,

RR,

Vamsi Krishna

et al. 2024

Journal of Neonatology

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Background: KMC is a global standard for LBW and preterm neonates, supported by evidence for reducing morbidities and mortality. Integrated into India’s Newborn Action Plan since 2014, aiming for single-digit neonatal mortality by 2030, KMC practices in India have not reached the optimal levels. Hence, we attempted to study the KMC practices in tertiary care NICUs across India. Methods: A cross-sectional online national survey among neonatologists in level III NICUs in India was conducted. Utilizing Google Forms and a structured questionnaire of 30 questions on KMC, one respondent per unit participated. Results: Of the 110 NICUs invited to participate, a total of 52 units responded (47.3%). All units have a written KMC policy and conventionally provide KMC to neonates with BW < 2000 g, while 36.5% units provide KMC for neonates with BW between 2000 and 2500 g. Though 86.5% of NICUs provide KMC to infants on respiratory support, only 13.5% practice KMC for mechanically ventilated neonates. The time to initiate KMC within 48–72 hours is prevalent in 44.2% of NICUs, with 54% of NICUs providing an average KMC duration of 4–8 hours/day. A significantly lower percentage of NICUs (28.9%) have a KMC follow-up program. Conclusion: The study highlights the need to boost the ongoing KMC training programs for HCWs to increase the coverage of KMC for LBWs and sick preterm neonates. This includes requiring more uniform and structured KMC practices across the country, especially upscaling of infrastructure, earlier initiation and longer duration of KMC, better monitoring of neonates in KMC, and strengthening the follow-up program.

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