Paediatrica Indonesiana (Mar 2012)
Supporting factors and barriers in implementing kangaroo mother care in Indonesia
Abstract
Background Kangaroo mother care (KMC) was introduced to Indonesia in the 1990s. Since then, KMC has not been widely implemented and has not received national policy support. Objective The objectives of this case study were to implement KMC by an intervention that would ultimately benefit ten hospitals in Java, Indonesia, as well as identify supporting factors and barriers to KMC implementation. Methods An intervention with four phases was conducted in ten hospitals. Two teaching hospitals were supported to serve as training centers, six hospitals were supported to implement KMC and two other hospitals were supported to strengthen existing KMC practices. The four phases were comprised of a baseline assessment, a five-day training workshop, two supervisory visits to each hospital, and an end-line assessment. Results A total of 344 low birth weight infants received KMC during the intervention period. Good progress with regards to implementation was observed in most hospitals between the first and second supervisory visits. Supporting factors for KMC were the following: support received from hospital management, positive attitudes ofhealthcare providers, patients, families and communities, as well as the availability of resources. The most common challenges were record keeping and data collection, human resources and staff issues, infrastructure and budgets, discharge and follow-up, as well as family issues. Challenges related to the family were the inability of the mother or family to visit the infant frequently to provide KMC, and the affordability of hospital user fees for the infant to stay in the hospital for a sufficient period of rime. Conclusion KM C appeared to be well accepted in most hospitals. For an intervention to have maximum impact, it is important to integrate services and maintain a complex network of communication systems. [Paediatr lndones. 2012;52:43-50).
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