Kangaroo Mother Care (KMC) is an evidence-based intervention, recommended by the World Health Organization, with the potential to prevent neonatal deaths and morbidity among low-birthweight and preterm babies. In Bangladesh, where the number of neonatal deaths is high, KMC is identified as a priority intervention to be scaled up in the country. Our aim was to explore the experiences of caregivers and healthcare providers (HCPs) of KMC in Bangladesh. We conducted semi-structured interviews in two hospitals in Dhaka, where KCM service was provided. In Study I, we interviewed fifteen caregivers. The results showed conducive conditions for caregivers to perform KMC at the hospital and at home, but support is needed from both healthcare providers and their families. Caregivers felt empowered and motivated when they observed improvements in the child's well-being. However, there are challenges to KMC implementation due to the struggle to keep the baby skin-to-skin, pain after caesarean section, delayed initiation of KMC, and routines that promote an initial separation between the mother and baby. In Study II, we interviewed eleven HCPs. The results showed that HCPs experienced KMC as a continuous process that requires both support and counselling, adapted to caregivers’ needs. Commitment, supervision, and training are necessary. However, there are structural conditions that challenge KMC implementation, including clinical routines that promote the initial separation of the mother and baby, staff shortages, and incomplete follow-up. In conclusion, the findings from this exploratory research can inform the design of interventions for scaling up KMC in Bangladesh. Caregivers' and HCPs' experiences show that continuous support, counselling, and family involvement are essential in the care, and that providing KMC empowers caregivers. Their experiences also indicate that KMC is sub-optimally implemented due to structural conditions and routines that need to be addressed to scale up KMC in the country by avoiding the initial separation of mother and baby, meeting the mothers' needs for care and support, and strengthening the follow-up. Our results also suggest a need to update clinical practices in line with the new WHO recommendations. / <p></p><p></p><p></p>
| Identifer | oai:union.ndltd.org:UPSALLA1/oai:DiVA.org:uu-525272 |
| Date | January 2024 |
| Creators | Sjömar, Johanna |
| Publisher | Uppsala universitet, Institutionen för kvinnors och barns hälsa, Uppsala |
| Source Sets | DiVA Archive at Upsalla University |
| Language | English |
| Detected Language | English |
| Type | Licentiate thesis, comprehensive summary, info:eu-repo/semantics/masterThesis, text |
| Format | application/pdf |
| Rights | info:eu-repo/semantics/openAccess |
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