دورية أكاديمية
Scaling up Kangaroo Mother Care in Ethiopia and India: a multi-site implementation research study
| العنوان: | Scaling up Kangaroo Mother Care in Ethiopia and India: a multi-site implementation research study |
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| المؤلفون: | Anayda Portela, Rajiv Bahl, Sarmila Mazumder, Nita Bhandari, Jose Martines, Lynn M Sibley, Ramesh Agarwal, Gary L Darmstadt, Khalid Aziz, Thomas Brune, Araya Abrha Medhanyie, Selemawit Asfaw Beyene, John N Cranmer, Dereje Duguma, Addisalem Fikre, Abebe Gebremariam Gobezayehu, H L Mohan, Arin Kar, Raghav Krishna, Aarti Kumar, Vishwajeet Kumar, Mulusew Lijalem Belew, Prem K Mony, Abiy Seifu Estifanos, Henok Tadele, Abraham Tariku, Birkneh Tilahun Tadesse, Marta Yemane Hadush, Grace J Chan, Krishnamurthy Jayanna, Tarun Kumar, Pankaj Kumar, Sonia Trikha, Damen HaileMariam, Alok Kumar, Arun Singh Jadaun, Fitsum W/Gebriel, Lamesgin Alamineh, Maryann Washington, Dejene Hailu Kassa, Hajira Amin Mohammed, Tedros Hailu Abay, Fisseha Ashebir Gebregizabher, Selamawit Mengesha Bilal, Mesfin Kote Debere, Suresh Kumar Dalpath, Samson Yohannes Amare, Arti Sahu, Prabhu Deva Gowda, Pramod Kumar Singh, Dawit Seyoum Gebremariam, Harsh Vardhan Jaiswal, Suman Rao PN |
| المصدر: | BMJ Global Health, Vol 6, Iss 9 (2021) |
| بيانات النشر: | BMJ Publishing Group, 2021. |
| سنة النشر: | 2021 |
| المجموعة: | LCC:Medicine (General) LCC:Infectious and parasitic diseases |
| مصطلحات موضوعية: | Medicine (General), R5-920, Infectious and parasitic diseases, RC109-216 |
| الوصف: | Objectives Kangaroo Mother Care (KMC), prolonged skin-to-skin care of the low birth weight baby with the mother plus exclusive breastfeeding reduces neonatal mortality. Global KMC coverage is low. This study was conducted to develop and evaluate context-adapted implementation models to achieve improved coverage.Design This study used mixed-methods applying implementation science to develop an adaptable strategy to improve implementation. Formative research informed the initial model which was refined in three iterative cycles. The models included three components: (1) maximising access to KMC-implementing facilities, (2) ensuring KMC initiation and maintenance in facilities and (3) supporting continuation at home postdischarge.Participants 3804 infants of birth weight under 2000 g who survived the first 3 days, were available in the study area and whose mother resided in the study area.Main outcome measures The primary outcomes were coverage of KMC during the 24 hours prior to discharge and at 7 days postdischarge.Results Key barriers and solutions were identified for scaling up KMC. The resulting implementation model achieved high population-based coverage. KMC initiation reached 68%–86% of infants in Ethiopian sites and 87% in Indian sites. At discharge, KMC was provided to 68% of infants in Ethiopia and 55% in India. At 7 days postdischarge, KMC was provided to 53%–65% of infants in all sites, except Oromia (38%) and Karnataka (36%).Conclusions This study shows how high coverage of KMC can be achieved using context-adapted models based on implementation science. They were supported by government leadership, health workers’ conviction that KMC is the standard of care, women’s and families’ acceptance of KMC, and changes in infrastructure, policy, skills and practice.Trial registration numbers ISRCTN12286667; CTRI/2017/07/008988; NCT03098069; NCT03419416; NCT03506698. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2059-7908 |
| العلاقة: | https://gh.bmj.com/content/6/9/e005905.fullTest; https://doaj.org/toc/2059-7908Test |
| DOI: | 10.1136/bmjgh-2021-005905 |
| الوصول الحر: | https://doaj.org/article/f9e42a20c4b24578b18e923f8f7db950Test |
| رقم الانضمام: | edsdoj.f9e42a20c4b24578b18e923f8f7db950 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 20597908 |
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| DOI: | 10.1136/bmjgh-2021-005905 |