Effective Early Kangaroo Mother Care Coverage and Associated Factors among Low- Birth-Weight Neonates in Selected Hospitals in Oromia Region, Ethiopia
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Date
2023-11
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Addis Ababa University
Abstract
Background: Globally, an estimated 13.4 million newborns were born preterm in 2020, with
Southern Asia and sub-Saharan Africa contributing to 65% of cases. Despite the WHO
endorsement of KMC for preterm infants, global KMC rates remained below 5% in 2021. In
Ethiopia, despite efforts to expand KMC, less than 10% of eligible newborns received any form
of KMC in 2021.
Objective: This study aimed to determine the coverage of effective early Kangaroo Mother Care
(EeKMC), examine associated factors, and identify facilitators and barriers to EeKMC initiation
among <2000grams newborns in selected hospitals in the Oromia region, Ethiopia, in 2023.
Methods: A facility-based cross-sectional study utilizing mixed methods was conducted.
Secondary data were employed to determine EeKMC coverage (which is defined as proportion
of <2,000g newborns for whom KMC, consisting of at least 8 hours of skin-to-skin care plus
exclusive breast milk feeding, was provided within 24 hours after birth) and associated factors,
while in-depth interviews and observations were carried out to explore barriers and facilitators of
effective early KMC. The study spanned one year, from October 2022 to November 2023. We
included 713 eligible low-birth-weight newborns in the quantitative data analysis. We applied
bivariate and multivariate logistic regression analyses, with a significance level set at p < 0.05.
We used thematic analysis to analyze the qualitative data.
Result: Among 713 <2,000g newborns 4.6% (33/713) received EeKMC, while 55.5% (396/713)
received exclusive breast milk feeding within 24 hours after birth. Newborns in the incubator
(compared to those outside) [AOR=0.07; 95% CI (0.015-0.34)] were less likely to receive
EeKMC.
Our qualitative data identified health system related barriers to EeKMC including inadequate
healthcare infrastructure, skill gaps, low motivation of healthcare provider, maternal emotional
status, post-operative pain, lack of knowledge about KMC, and cultural norms that hasten
mothers to go home after birth. Facilitators comprise quality improvement initiatives, visual
aids, effective counseling, maternal willingness and regular pregnancy follow-up.
Conclusion and recommendation: Our study found that the coverage of EeKMC is low.
Comprehensive interventions addressing issues ranging from healthcare infrastructure
inadequacies to cultural norms should be implemented.
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Keywords
Oromia, effective KMC, early KMC, enablers, barriers.