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07.05.2017 Category: News

Barriers and enablers of health system adoption of kangaroo mother care

A systematic review of caregiver perspectives


Picture: A mother is kangarooing her preterm infant

Complications related to preterm birth or low birthweight are the main reasons for infant mortality. Kangaroo Mother Care (KMC) has proven to be an effective life-saving method for at-risk babies. Nevertheless, it has not been fully integrated into health systems around the world. BMC Pediatrics recently published a study by Smith et al. which identifies reasons and obstacles for the fragmentary implementation of KMC.

While the child death rate is globally declining, still approximately 6.3 million children die before reaching the age of five. Preterm born babies are an especially vulnerable patient group in this context which highlights the need to implement measures to improve the starting conditions for premature babies. Despite its scientific verification and the recent recommendation by the WHO outlining the KMC method as an essential routine in the care for newborns. KMC has not been applied in worldwide health systems yet. One reason for this deficiency might be medical and parental caregivers facing obstacles in implementing or carrying out KMC. This study therefore focuses on barriers and enablers of implementing and scaling up KMC from the caregivers’ perspective. By evaluating substantial qualitative research and examining a large number of publications using standardized questionnaires, the study identified aspects that turned out as either barriers or enablers for KMC.

While a lack of funds, a lack of time at the hospital or medical concerns about the well-being of mother and child were a significant barrier to integrate KMC, socio-cultural aspects, such as traditions, gender roles and the role of men in childcare, sometimes hold back the uptake of KMC. Bureaucratic hurdles and the lack of private spaces for parents and their newborn child are additional obstacles to scale up KMC. The study emphasizes the value of KMC programs as they can positively contribute to the infant’s well-being and encourages political actors and public health professionals to become familiar with the complex context of neonatology and the needs of caregivers of preterm and low birthweight infants.


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