Logo: to the web site of Uppsala University

uu.sePublications from Uppsala University
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Exploring caregivers' experiences of Kangaroo Mother Care in Bangladesh: A descriptive qualitative study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, SWEDESD - Sustainability Learning and Research Centre.ORCID iD: 0000-0003-3104-8763
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Child Health and Nutrition.
Int Ctr Diarrhoeal Res, Maternal & Child Hlth Div, Dhaka, Bangladesh..
Int Ctr Diarrhoeal Res, Maternal & Child Hlth Div, Dhaka, Bangladesh..
Show others and affiliations
2023 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 1, article id e0280254Article in journal (Refereed) Published
Abstract [en]

Background

Kangaroo Mother Care (KMC) is an evidence-based intervention recommended by the World Health Organization (WHO) to reduce preterm mortality and morbidity. The aim of this study was to explore caregivers’ experiences of providing KMC in hospital settings and after continuation at home in Bangladesh in order to assess enablers and barriers to optimal implementation.

Methods

Interviews with fifteen caregivers were conducted using an interview guide with semi-structured questions in August 2019 and March 2020. Convenience sampling was used to select hospitals and participants for the study. The inclusion criteria were being a caregiver currently performing KMC in the hospital or having been discharged one week earlier from the KMC ward. The interviews were audio recorded, transcribed verbatim, and translated. The data were analyzed using thematic analysis with an inductive approach.

Results

Three themes were identified as regards the caregivers’ experiences of providing KMC: conducive conditions, an empowering process, and suboptimal implementation. The results showed that there are supporting circumstances for caregivers performing KMC in Bangladesh, including social support structures and positive attitudes to the method of care. It also appeared that the caregivers felt strengthened in their roles as caregivers by learning and performing KMC. However, the implementation of KMC was suboptimal due to late initiation of KMC, difficulties with keeping the baby skin-to-skin, and pain after cesarean section hampering skin-to-skin practice.

Conclusions

The social and cultural conditions for the caregivers to perform KMC as well as the empowerment the parents felt in their roles as caregivers when performing KMC are facilitating factors for this method of care. Initial separation and late initiation of KMC, as well as disregard for the mothers’ needs for care and support, were barriers to optimal practice leading to missed opportunities. These facilitators and barriers need to be addressed in order to succeed in scaling up the national KMC program.

Place, publisher, year, edition, pages
Public Library of Science (PLoS), 2023. Vol. 18, no 1, article id e0280254
National Category
Nursing
Identifiers
URN: urn:nbn:se:uu:diva-499899DOI: 10.1371/journal.pone.0280254ISI: 000945400200001PubMedID: 36689433OAI: oai:DiVA.org:uu-499899DiVA, id: diva2:1749401
Funder
Insamlingsstiftelsen Födelsefonden - Perinatalmedicinska forskningsfonden i UppsalaGillbergska stiftelsen
Note

De två första författarna delar förstaförfattarskapet

Available from: 2023-04-06 Created: 2023-04-06 Last updated: 2024-03-20Bibliographically approved
In thesis
1. Kangaroo Mother Care in Bangladesh: Experiences of Caregivers and Healthcare Providers
Open this publication in new window or tab >>Kangaroo Mother Care in Bangladesh: Experiences of Caregivers and Healthcare Providers
2024 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

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.

Place, publisher, year, edition, pages
Uppsala: Uppsala University, 2024. p. 56
Keywords
Kangaroo Mother Care, skin-to-skin care, experience of care, provision of care, caregiver, healthcare provider, neonatal health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
International Health
Identifiers
urn:nbn:se:uu:diva-525272 (URN)
Presentation
2024-05-03, H:son-Holmdahlsalen, Dag Hammarsköldsväg 8, ingång 100 Akademiska Sjukhuset, 753 09 Uppsala, 09:00 (English)
Supervisors
Note

Available from: 2024-04-08 Created: 2024-03-20 Last updated: 2024-04-10Bibliographically approved

Open Access in DiVA

fulltext(435 kB)156 downloads
File information
File name FULLTEXT01.pdfFile size 435 kBChecksum SHA-512
32f8948646f1d6a31e635169c173e2f4e8efc73b389effad5c6b5aa2aea1348e9faec30fca623d975306fc5154c035c9e2ff6aaa61101967a46352ac3f32f009
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Authority records

Sjömar, JohannaOttesen, HeddaThernström Blomqvist, YlvaMoshfiqur Rahman, SyedMålqvist, Mats

Search in DiVA

By author/editor
Sjömar, JohannaOttesen, HeddaThernström Blomqvist, YlvaMoshfiqur Rahman, SyedMålqvist, Mats
By organisation
SWEDESD - Sustainability Learning and Research CentreInternational Child Health and NutritionPerinatal, Neonatal and Pediatric Cardiology Research
In the same journal
PLOS ONE
Nursing

Search outside of DiVA

GoogleGoogle Scholar
Total: 158 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 108 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf