Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Science, University of KwaZulu-Natal, 2nd Floor George Campbell Building, Mazisi Kunene Road, Durban, 4041, South Africa.
School of Public Health, University of the Western Cape, Cape Town, South Africa.
BMC Pediatr. 2020 Jul 29;20(1):355. doi: 10.1186/s12887-020-02251-1.
Kangaroo Mother Care (KMC) is one of the interventions widely used in low-income countries to manage Low Birth Weight Infants (LBWIs), a global leading cause of neonatal and child mortality. LBWI largely contributes to neonatal mortality in Malawi despite the country strengthening and implementing KMC, nationwide, to enhance the survival of LBWIs. This qualitative study aimed to assess the facilitating factors and barriers to accessibility and utilization of KMC service by the parent of low birth weight infants (PLBWIs) in Mangochi District, Malawi.
Two focused group discussions assessed factors facilitating and hindering the accessibility and utilization of KMC service were conducted in April 2018 that reached out to (N = 12) participants; (n:6) PLBWI practicing KMC at Mangochi district hospital (MDH) referred from four health facilities and (n:6) high-risk pregnant mothers (HRPMs) visiting antenatal care (ANC) clinic at MDH. The availability of KMC at MDH was assessed using KMC availability checklist. The study used purposive, convenient and simple random sampling to identify eligible participants. Thematic analysis was used to analyze the findings.
Sixteen themes emerged on facilitating factors and barriers to accessibility and utilization of KMC service by the PLBWIs. The identified themes included; availability of KMC providers, social factor (social support and maternal love), timing of KMC information, knowledge on KMC, health linkage systems, recognition of LBWIs, safety on the use of KMC, preference of LBWI's care practice, lived experience on KMC practice, KMC expert clients, perceived causes of LBWI births, cultural/traditional factors, religious beliefs, health-seeking behavior, women empowerment and quality of care.
Although KMC was available in some of the health facilities, integration of KMC messages in ANC guidelines, community awareness and in sensitization of any health intervention may enhance KMC accessibility and utilization by the targeted population.
袋鼠式护理（KMC）是低收入国家广泛用于管理低出生体重婴儿（LBWI）的干预措施之一，LBWI 是全球新生儿和儿童死亡的主要原因。尽管马拉维全国加强并实施了 KMC 以提高 LBWI 的生存率，但 LBWI 仍然是该国新生儿死亡的主要原因。本定性研究旨在评估马乔奇地区父母获得和利用 KMC 服务的促进因素和障碍，以照顾低出生体重婴儿（PLBWIs）。
2018 年 4 月进行了两次焦点小组讨论，以评估促进和阻碍 KMC 服务可及性和利用的因素，参与者有 12 人；（n：6）在马乔奇地区医院（MDH）接受 KMC 治疗的 PLBWI，由四家医疗机构转诊；（n：6）在 MDH 接受产前保健（ANC）诊所就诊的高危孕妇（HRPMs）。使用 KMC 可用性清单评估 MDH 提供 KMC 的情况。研究采用了目的性、方便性和简单随机抽样方法来确定合格的参与者。使用主题分析对研究结果进行分析。
PLBWIs 获得和利用 KMC 服务的促进因素和障碍共出现 16 个主题。确定的主题包括：KMC 提供者的可用性、社会因素（社会支持和母爱）、KMC 信息的时机、KMC 知识、健康联系系统、LBWI 的识别、KMC 使用的安全性、LBWI 护理实践的偏好、KMC 实践的生活经验、KMC 专家客户、LBWI 出生的感知原因、文化/传统因素、宗教信仰、寻求医疗行为、妇女赋权和护理质量。
尽管 KMC 在一些医疗机构中可用，但将 KMC 信息纳入 ANC 指南、提高社区意识和宣传任何卫生干预措施，可以增强目标人群对 KMC 的可及性和利用。
