Kangaroo mother care (KMC) is a high-impact, cost-effective and life-saving intervention in the care of preterm and low birthweight newborns. These babies need special care to keep warm and to feed. Instead of being kept in an incubator or placed under a radiant warmer, stable babies are placed skin-to-skin on the mother’s or other caregiver’s chest in an upright position and tied securely. Babies who are too immature to breastfeed and have difficulty in coordinating the suck-swallow-and-breathe movement receive expressed breastmilk through a gastric tube or with a cup. The mother is intimately involved with her baby and she becomes the primary caregiver with the support of the nursing, medical and allied health care staff. She learns the skill of taking care of her small baby and she is able to go home safely. Small newborns continue to receive KMC at home. They are still very vulnerable and should be followed up regularly by an experienced multidisciplinary team.
The KMC implementation research programme started in 1999 with the implementation of KMC at Kalafong Provincial Tertiary Hospital in Gauteng Province. At that time, the method was relatively unknown globally and in South Africa. There was nothing available to assist clinicians and managers on how to implement this new intervention and for which services they should plan. In the first few years, a number of outreach strategies were developed and tested with the aid of a multimedia package that included a workbook, a poster and a wrap for tying the baby. The evidence that emerged included a stages-of-change model and a tool to assess progress with KMC implementation based on this model. Members of the Centre are involved in the training of healthcare providers and the scale-up and assessment of KMC practice and services. Many African countries have benefitted from these activities, including Botswana, Chad, Comoros, Côte d’Ivoire, Ethiopia, Ghana, Kenya, Liberia, Mali, Malawi, Niger, Nigeria, Rwanda, Sudan, Tanzania, The Gambia, Togo and Uganda. Other countries that received training include Bangladesh, Indonesia, Germany, Iran, Iraq and Syria, The stages-of-change model is transferable to other interventions and has been used in the scale-up of the Essential Steps in the Management of Obstetric Emergencies (ESMOE), for understanding and assessing the implementation of maternal and perinatal death audit systems, and for implementing PMTCT and HIV- prevention programmes. |
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