Feasibility of Kangaroo Mother Care (KMC) Implementation in Depok City, Indonesia

Amelia, Tiara; Pratomo, Hadi; Adisasmita, Asri C.; Martha, Evi; Rustina, Yeni; Murty, Ade Iva; Susilowati, Indri Hapsari; Tambunan, Eviana S.; Hasanah, Indah Jamiatun

doi:10.1177/2333794x211012390

Cited by 4 publications

(7 citation statements)

References 7 publications

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“…All neonates with birth weight less than 2.0 kilograms (kg) and their mothers/alternate KMC providers were considered eligible for the study. An alternate KMC provider is any family member who is ready to spend quality time for KMC other than the mother [ 11 , 12 ].…”

Section: Methodsmentioning

confidence: 99%

Improving the Duration and Rate of Home-Based Kangaroo Mother Care: A Before-and-After Intervention Study

Patawat¹,

Choudhary²,

Jain³

et al. 2023

Cureus

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IntroductionKangaroo mother care (KMC) is an evidence-based, simple, time-tested, low-cost, and high-impact intervention for neonatal survival in hospitals and the community, particularly in resource-constrained areas. This has many beneficial effects on sick and stable low-birth-weight babies, lactating mothers, families, society, and the government. However, despite the World Health Organization (WHO) and United Nations International Children's Emergency Fund (UNICEF) recommendations for KMC, there is no satisfactory implementation of it in the community as well as in facilities. This study aimed to improve the duration of home-based kangaroo mother care (HBKMC). Material and methodsWe conducted a before-and-after intervention hospital-based, single-center study in a level III neonatal intensive care unit (NICU) to improve the duration of HBKMC. The KMC duration was classified into four categories: short, extended, long, and continuous where KMC was provided for 4 hours/day, 5-8 hours/day, 9-12 hours/day, and more than 12 hours/day, respectively. All neonates with birth weight < 2.0 kg and their mothers/alternate KMC providers at a tertiary care hospital in India in the time period of five months from April 2021 to July 2021 were considered eligible for the study. We tested three sets of interventions by using the plan-do-study-act cycle (PDSA cycle). The first set of interventions was the sensitization of parents and healthcare workers regarding the benefits of KMC by comprehensive counseling to mothers and other family members using educational lectures, videos, charts, and posters. The second set of interventions was to reduce maternal anxiety/stress while maintaining maternal privacy by providing more female staff and teaching proper gown-wearing techniques. The third set of interventions was to solve lactation and environment temperature issues by providing antenatal and postnatal lactation counseling and warming of the nursery. The paired T-test and one-way analysis of variance (ANOVA) were used for statistical analysis, and p<0.05 was taken as significant. ResultsOne hundred and eighty neonates were enrolled along with their mothers/alternate KMC providers in four phases, and three PDSA cycles were implemented. Out of 180 LBW infants, 21 (11.67%) infants received KMC < 4 hours/day. According to the KMC classification, 31% have continuous KMC in the institution, followed by 24% long KMC, 26% extended KMC, and 18% short KMC. After three PDSA cycles, HBKMC was 38.88% continuous KMC, followed by 24.22% long KMC, 20.55% extended KMC, and 16.11% short KMC. Continuous KMC was improved from 21% to 46% at the institute and 16% to 50% at home from phase 1 to phase 4 of the study after the implementation of three sets of interventions in three PDSA cycles. The phase-by-phase KMC rate and duration were improved after the application of the PDSA cycles, and this was maintained in HBKMC as well, but it was statistically not significant. ConclusionSets of intervention packages based on needs analysis using the PDSA cyc...

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Section: Methodsmentioning

confidence: 99%

Improving the Duration and Rate of Home-Based Kangaroo Mother Care: A Before-and-After Intervention Study

Patawat¹,

Choudhary²,

Jain³

et al. 2023

Cureus

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“…A health education activity for parents and the baby's family is making the families ready to use KMC in the house. This can boost family confidence in caring for LBW babies [ 9 ].…”

Section: Reviewmentioning

confidence: 99%

“…It is an easy and efficient way to upgrade the health and growth of premature LBW infants and full-term infants [ 8 ]. In 1979, Dr. Hector Martinez and Dr. Edgar Rey, both pediatricians working at Bogota Hospital in Colombia, first introduced LBW care by adopting KMC [ 9 ]. In the year 1983, the United Nations Children's Fund (UNICEF) launched this technique in other nations including LMICs [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Kangaroo Mother Care for Low-Birth-Weight Babies in Low and Middle-Income Countries: A Narrative Review

Dhage¹,

Rannaware²,

Choudhari³

2023

Cureus

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In low and middle-income countries (LMICs), the infant mortality rate is much higher than the high-income countries (HICs). The higher infant mortality is due to low birth weight (LBW) a combination of intra-uterine growth retardation (IUGR) and prematurity, which are risk factors for acquiring infectious diseases amongst newborns. Kangaroo mother care (KMC) is a neonatal procedure that is carried out in newborn infants, especially in preterm babies and LBW babies. It is skin-to-skin contact between a mother’s bare chest and a stable infant. KMC is an important intervention in reducing infant mortality rates in LMICs. A comprehensive literature and data search was done using key databases like PubMed and Google Scholar. A total of 42 articles out of 1,168 articles were selected for review after screening and elimination of the repeated articles. Through this review we have tried to analyse the benefits of KMC in newborns, the need for the participation of fathers and family members, and the need for implementation of this practice at a broader level by policy formulation in LMICs. We have also discussed the need for KMC for the prevention of infant mortality in LBW newborns in LMICs.

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“…Strong local leadership, availability of well-equipped KMC units, trained personnel, and supplies were shown to support effective KMC implementation in Africa [ 14 , 16 , 17 ]. Notably, family unreadiness and the absence of fully functional referral systems were identified as significant barriers in Indonesia and Pakistan, respectively [ 15 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

“…In comparison to standard conventional care, it has also been found to reduce the duration of hospital stay and neonatal morbidity primarily from infection [11]. Numerous studies have explored the facilitators and challenges of implementing KMC in hospitals in different settings [14][15][16][17][18]. Strong local leadership, availability of well-equipped KMC units, trained personnel, and supplies were shown to support effective KMC implementation in Africa [14,16,17].…”

Section: Introductionmentioning

confidence: 99%

Strengthening Kangaroo Mother Care at a tertiary level hospital in Zambia: A prospective descriptive study

et al. 2022

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Background Globally, complications due to preterm birth are the leading contributor to neonatal mortality, resulting in an estimated one million deaths annually. Kangaroo Mother Care (KMC) has been endorsed by the World Health Organisation as a low cost, safe, and effective intervention in reducing morbidity and mortality among preterm infants. The objective of this study was to describe the implementation of a KMC model among preterm infants and its impact on neonatal outcomes at a tertiary level hospital in Lusaka, Zambia. Methods We conducted a prospective descriptive study using data collected from the KMC room at the University Teaching Hospital between January 2016 and September 2017. Mothers and government nurses were trained in KMC. We monitored skin-to-skin and breastfeeding practices, weight at admission, discharge, and length of admission. Results We enrolled 573 neonates into the study. Thirteen extremely low weight infants admitted to the KMC room had graduated to Group A (1,000g-1,499g) at discharge, with a median weight gain of 500g. Of the 419 very low weight neonates at admission, 290 remained in Group A while 129 improved to Group B (1,500g-2,499g), with a median weight gain of 280g. Among the 89 low weight neonates, 1 regressed to Group A, 77 remained in Group B, and 11 improved to Group C (≥2,500g), individually gaining a median of 100g. Of the seven normal weight neonates, 6 remained in Group C individually gaining a median of 100g, and 1 regressed to Group B. Among all infants enrolled, two (0.35%) died in the KMC room. Conclusions Based on the RE-AIM metrics, our results show that KMC is a feasible intervention that can improve neonatal outcomes among preterm infants in Zambia. The study findings show a promising, practical approach to scaling up KMC in Zambia. Trial registration The trial is registered under ClinicalTrials.gov under the following ID number: NCT03923023.

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Feasibility of Kangaroo Mother Care (KMC) Implementation in Depok City, Indonesia

Cited by 4 publications

References 7 publications

Improving the Duration and Rate of Home-Based Kangaroo Mother Care: A Before-and-After Intervention Study

Improving the Duration and Rate of Home-Based Kangaroo Mother Care: A Before-and-After Intervention Study

Kangaroo Mother Care for Low-Birth-Weight Babies in Low and Middle-Income Countries: A Narrative Review

Strengthening Kangaroo Mother Care at a tertiary level hospital in Zambia: A prospective descriptive study

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