Launching continuous kangaroo mother care through participatory action research in Iran

Abstract

Background This study describes the launching of a unit for continuous kangaroo mother care (KMC) in a teaching hospital (Taleghani) in Iran. Methods We used a participatory three-stage action research approach to establish a unit for continuous KMC: design (needs identification and planning for change); implementation (and reflection); and evaluation (and institutionalization). As part of the design and implementation stages, individual and focus group interviews were conducted with mothers, physicians, nurses, other healthcare personnel and policy makers. The evaluation was done by means of a standardized tool specifically developed for monitoring progress with the implementation of KMC. Results Four themes relating to potential barriers to implementation emerged from the analysis of the staff interviews, namely barriers associated with the mother, the father, the physician and the health system. Mothers’ experiences of barriers were grouped into five themes: personal discomfort, fear, healthcare provider attitudes and actions, infrastructure constraints and family matters. An implementation progress score of 27.05 out of 30 was achieved, indicating that the continuous KMC unit was on the path to institutionalization. Some of the gaps identified related to policies on resource allocation, the discharge and follow-up system, and the transportation of infants in the KMC position. Conclusion The study findings indicated that participatory action research is a suitable method for studying the establishment of a continuous KMC unit. When action research is practiced, there is a prospect of turning knowledge into action in the real world.

Feasibility and acceptability of a novel biomedical device to prevent neonatal hypothermia and augment Kangaroo Mother Care in Kenya: Qualitative analysis of focus group discussions and key Informant Interviews

“…While “continuous” KMC/STS (i.e., 24 hours a day of uninterrupted skin-to-skin contact) is often the recommended best practice for small babies, pragmatically, this standard is often very difficult to achieve–in some cases, due to pain and fatigue among maternal caregivers, lack of availability of health workers and/or family members to provide on-going support, and various health system factors. [ 34 – 36 ] More commonly, “intermittent” KMC/STS is practiced [ 37 ]. Thus, the stand-alone mode was developed to ensure that, even when an adult caregiver had to take a break from KMC/STS, for example, to attend to personal needs (e.g., bathe) or rest, that the infant was still receiving seamless thermal support, even in environments with a paucity of incubators.…”

“…Poor infrastructure and inadequate logistics within healthcare facilities is a particularly challenging barrier to KMC/STS, since hospitals often do not have space, privacy, or a comfortable environment to support continuous KMC. [16,19,36,[59][60][61][62] In some settings, units such as the NICU have limited visitation policies that interfere with adult-baby dyads engaging in KMC/STS. [63] In contexts where lack of a formal KMC ward, or limited space, lack of privacy, or hospital policy limits mother and baby contact, Kenyan interviewees suggested NeoWarm can be a viable way to augment thermal care.…”