Magister Public Health - MPH / Kangaroo mother care (KMC) was first initiated in Colombia due to shortages of incubators and the incidence of severe hospital infections of new-born infants during hospital stay (Feldman, 2004). Currently it is identified by UNICEF as a universally available and biologically sound method of care for all new-borns, particularly for low birth weight infants (Department of Reproductive Health and Research, 2003) in both developed and developing countries. The Western Cape Provincial Government implemented a policy on KMC as part of their strategy to decrease the morbidity and mortality of premature infants in 2003 (Kangaroo Mother Care Provincial task team, 2003). Essential components of KMC are: skin-to-skin contact for 24 hours per day (or as great a part of the day as possible), exclusive breastfeeding and support to the motherinfant dyad. Successful implementation of KMC requires relevant education of nurses, education of mothers on KMC by nursing staff, monitoring of the implementation of KMC by nurses, planning for a staff mix with varying levels of skill and experience with KMC, the identification of institution specific barriers to the implementation of KMC, and the implementation of institution specific strategies to overcome these barriers (Wallin,et al., 2005; Bergman & Jurisco, 1994; Cattaneo, et al., 1998). This study aims to determine the knowledge of and attitude towards kangaroo mother care, of nursing staff and kangaroo mothers in the Eastern sub-district of Cape Town. / South Africa

Bakgrund: Nollseparation har ingen tydlig definition och tycks vara ett relativt nytt begrepp som används inom förlossnings- och eftervården. Det framgår tydliga riktlinjer om att barnet ska ligga hud mot hud med sin moder efter förlossningen. Men i vissa fall separeras modern och barnet av olika anledningar. Barnmorskan har en central roll i vården av nyförlösta kvinnor och deras nyfödda barn.Syfte: Syftet med studien var att analysera och definiera begreppet nollseparation mellan förälder och nyfött barn ur ett barnmorskeperspektiv.Metod: En begreppsanalys baserad på en hybridmodell. Hybridmodellen är uppdelad i en teoretisk fas med litteratursökning, en fältstudiefas baserad på intervjuer av sex kliniskt verksamma barnmorskor samt en sammanfattande syntetiseringsfas.Resultat: Nollseparation är likställt med; hud mot hud-kontakt, att alltid ha en förälder närvarande, att familjen ska få vara tillsammans samt att samarbete mellan olika vårdinstanser för att bedriva samvård krävs för att upprätthålla nollseparationen. Barnmorskan får en betydelsefull nyckelfunktion i upprätthållandet av nollseparation.Slutsats: Nollseparation är ett paraplybegrepp som involverar hud mot hud-kontakt, förälders närvaro, att familjen ska få vara tillsammans, att det ska finnas en fungerande samvård mellan olika instanser samt att det ingår i barnmorskans arbetsuppgifter att främja nollseparation.Klinisk tillämpbarhet: Resultatet från detta examensarbete kan komma till nytta inom förlossnings- och eftervården, men kompetensen behöver även ökas inom andra instanser i sjukvården som kan komma i kontakt med nyfödda barn och deras föräldrar. / Background: Zero-separation has no distinct definition and appears to be a relatively new concept used in delivery- and postpartum care. There are obvious guidelines that the child should be skin-to-skin with the mother after birth. But in some cases the mother and child are separated for different reasons. The midwife has a central part in the care of emergent mothers’ and their newborn children.Aim: The aim in this study was to analyze and define the concept of zero-separation between parent and infant from a midwifes’ perspective.Method: A concept analysis based on a hybridmodel. The hybrilmodel is divided into a theoretical phase with literature search, a field study phase based on interviews with six clinically active midwives and a summary synthesis phase.Results: Zero-separation is equated with; skin-to-skin, always have a parent present, the family being together always and that couplet care is needed to maintain zero-separation. The midwife has a significant keyrole in maintaining zero-separation. Conclusion: Zero-separation is an umbrellaconcept which involves skin-to-skin, parental presence, that the family should be allowed to be together, a functioning couplet care between different instances and that maintaining zero-separation is a part of the midwifes’ assignments.Clinical application: The results from this study can be useful in delivery- and aftercare, but the competence needs to be increased in other instances in healthcare that may come in contact with newborn children and their parents.