Bergh A-M, Manu R, Davy K, Van Rooyen E, Quansah Asare G, Awoonor-Williams Jk, Dedzo M, Twumasi A, Nang-Beifubah A
MRC Unit for Maternal and Infant Health Care Strategies, University of Pretoria, South Africa.
Ghana Med J. 2013 Jun;47(2):57-63.
To measure progress with the implementation of kangaroo mother care (KMC) for low birth-weight (LBW) infants at a health systems level.
Action research design, with district and regional hospitals as the unit of analysis.
Four regions in Ghana, identified by the Ghana Health Service and UNICEF.
Health workers and officials, health care facilities and districts in the four regions.
A one-year implementation programme with three phases: (1) introduction to KMC, skills development in KMC practice and the management of implementation; (2) advanced skills development for regional steering committee members; and (3) an assessment of progress at the end of the intervention.
Description of practices, services and facilities for KMC and the identification of strengths and challenges.
Twenty-six of 38 hospitals (68%) demonstrated sufficient progress with KMC implementation. Half of the hospitals had designated a special ward for KMC. 66% of hospitals used a special record for infants receiving KMC. Two of the main challenges were lack of support for mothers who had to remain with their LBW infants in hospital and no follow-up review services for LBW infants in 39% of hospitals.
It was possible to roll out KMC in Ghana, but further support for the regions is needed to maintain the momentum. Lessons learned from this project could inform further scale-up of KMC and other projects in Ghana.
在卫生系统层面衡量低出生体重（LBW）婴儿袋鼠式护理（KMC）的实施进展。
以地区和区域医院为分析单位的行动研究设计。
由加纳卫生服务局和联合国儿童基金会确定的加纳四个地区。
四个地区的卫生工作者和官员、医疗保健机构及地区。
一个为期一年的实施计划，分为三个阶段：（1）介绍KMC、KMC实践技能发展及实施管理；（2）为区域指导委员会成员开展高级技能培训；（3）在干预结束时评估进展情况。
描述KMC的实践、服务和设施，并确定优势与挑战。
38家医院中的26家（68%）在KMC实施方面取得了足够进展。一半的医院设有KMC专用病房。66%的医院为接受KMC的婴儿使用专门记录。两个主要挑战是，对于必须在医院陪伴其低出生体重婴儿的母亲缺乏支持，以及39%的医院没有为低出生体重婴儿提供后续复查服务。
在加纳推广KMC是可行的，但需要为各地区提供进一步支持以保持这一势头。从该项目中吸取的经验教训可为加纳进一步扩大KMC及其他项目提供参考。
