Barriers and Enablers of KMC Implementation in Health Facility and Community of Tigray Region, Northern Ethiopia: Formative Research

Abstract

Marta Yemane Hadush,1 Dawit Seyoum Gebremariam,1 Selemawit Asfaw Beyene,2 Tedros Hailu Abay,1 Amanuel Hadgu Berhe,1 Yibrah Berhe Zelelew,1 Tirhas Asmelash,3 Fisseha Ashebir,3 Samson Yohannes Amare,4 Znabu Hadush,2 Araya Abrha Medhanyie2 1School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 2School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 3Tigray regional health bureau, Mekelle, Ethiopia; 4School of Computing, Mekelle University, Mekelle, EthiopiaCorrespondence: Marta Yemane Hadush, Email [email protected]: Kangaroo mother care (KMC) is an evidence-based approach to reducing morbidity and mortality in low-birth-weight and preterm newborns. Barriers for KMC and its effective practice at a larger scale are highly affected by contextual factors. The purpose of this study is to explore barriers and enablers in the community and health facilities for implementation and continuation of KMC.Methods: This formative study employed a qualitative exploratory approach using focus group discussions and in-depth interviews in five zones of Tigray region, Northern Ethiopia. A total of 16 focus group discussions and 46 in-depth interviews were conducted with health workers and community members. The whole process of data collection took an iterative approach. An inductive thematic analysis was done by going through the transcribed data using ATLAS.ti software.Results: The current study found that problems of infrastructure and equipment for KMC practice, shortage of staff, and absence of trained health workers as the most frequently mentioned barriers by health workers. Low level of awareness, lack of support, mother being responsible for the rest of the family, holding babies in the front being traditionally unacceptable, and preference of incubators for better care of small babies were among the barriers identified in the community. Presence of community health workers and the positive attitude of the community towards them, as well as antenatal and postnatal care were among the favorable conditions for the implementation of KMC at health facilities and continuation of KMC at home.Conclusion: Empowering health workers through training to identify preterm and low-birth-weight babies, to do follow-ups after discharge, and creating awareness in the community to change the perception of kangaroo mother care are necessary.Keywords: kangaroo mother care, KMC, implementation research, low birth weight, Ethiopia, newborn care, preterm birth, KMC implementation, enablers and barriers to KMC

Keywords

• kangaroo mother care
• kmc
• implementation research
• low birth weight
• ethiopia
• newborn care
• preterm birth
• kmc implementation
• enablers and barriers to kmc