Save the Children, Lilongwe, Malawi.
Department of Global Health, Save the Children US, Washington, DC, United States of America.
PLoS One. 2020 Mar 19;15(3):e0229720. doi: 10.1371/journal.pone.0229720. eCollection 2020.
Complications of prematurity are a leading cause of newborn death in Malawi. Despite early adoption of Kangaroo mother care (KMC), coverage remains low and women have expressed challenges in using the traditional wrapper-chitenje. In 2016, a study was conducted to evaluate the acceptability and effectiveness of a customized KMC wrap in improving adherence to KMC practices among mothers.
Mother-baby dyads (301) were randomized to receive either a customized CarePlus Wrap developed by Lærdal Global Health or a traditional chitenje. Enrolled mother-baby dyads were assessed in the KMC ward at 2-3 days after of admission, and then again at 7-15 days post-discharge. Topics covered included skin-to-skin practices, breastfeeding, perceptions of the wrap, and family/community support. Chi square tests were used to assess associations between wrap type and KMC practices. The study received ethics approval.
This study found that a customized KMC wrap is highly acceptable to women and improved skin-to-skin practices in facility-based KMC: 44% of mothers using a customized wrap reported 20 or more hours per day, compared to 33% of mothers using the traditional chitenje. Women using the customized wrap reported being comfortable in keeping the baby in skin-to-skin position more often than women using the chitenje (96% vs. 71%), and they were able to tie on the wrap themselves (86% vs. 10%). At the time of discharge from KMC, more women who used the customized wrap were satisfied with the wrap than those who used the traditional chitenje (94% vs. 56%). The customized wrap did not appear to impact other newborn practices, such as breastfeeding.
This study provides evidence that a customized KMC wrap is highly acceptable to mothers, and it can contribute to better skin-to-skin practices. Use of a customized wrap may be one mechanism to support mothers in practicing KMC and skin-to-skin contact in addition to other interventions.
早产并发症是马拉维新生儿死亡的主要原因。尽管袋鼠式护理（KMC）很早就被采用，但覆盖率仍然很低，而且妇女在使用传统的 chitenje 方面也遇到了挑战。2016 年，进行了一项研究，以评估定制 KMC 包裹在提高母亲对 KMC 实践的依从性方面的可接受性和有效性。
将 301 对母婴对随机分配接受由 Lærdal Global Health 开发的定制 CarePlus Wrap 或传统 chitenje。入组的母婴对在入院后 2-3 天在 KMC 病房进行评估，然后在出院后 7-15 天再次进行评估。涵盖的主题包括皮肤接触实践、母乳喂养、对包裹的看法以及家庭/社区支持。使用卡方检验评估包裹类型与 KMC 实践之间的关联。该研究获得了伦理批准。
这项研究发现，定制的 KMC 包裹非常受妇女欢迎，并改善了医疗机构内 KMC 的皮肤接触实践：使用定制包裹的 44%的母亲报告每天有 20 小时或更多时间，而使用传统 chitenje 的母亲则为 33%。使用定制包裹的妇女报告说，她们经常让婴儿保持皮肤接触的姿势更舒适，比使用 chitenje 的妇女更舒适（96%比 71%），并且她们能够自己系上包裹（86%比 10%）。在 KMC 出院时，使用定制包裹的妇女对包裹的满意度高于使用传统 chitenje 的妇女（94%比 56%）。定制包裹似乎没有影响其他新生儿实践，如母乳喂养。
这项研究提供了证据表明，定制的 KMC 包裹非常受母亲欢迎，并且可以促进更好的皮肤接触实践。使用定制包裹可能是支持母亲实践 KMC 和皮肤接触的一种机制，除了其他干预措施外。
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