Improving duration of kangaroo mother care by using quality improvement methodology of low-birth-weight neonates

Anita Mehta; Smriti Kumari; Vijay Shankar

doi:10.18203/2349-3291.ijcp20252963

Authors

Anita Mehta Department of Paediatrics, Baba Raghav Das Medical College, Gorakhpur, Uttar Pradesh, India
Smriti Kumari Department of Paediatrics, Autonomous State Medical College, Kushinagar, Uttar Pradesh, India https://orcid.org/0009-0003-9738-3158
Vijay Shankar Department of Surgery, Keshav Memorial Charity Medical College, Maharajganj, Uttar Pradesh, India https://orcid.org/0009-0005-3987-4877

DOI:

https://doi.org/10.18203/2349-3291.ijcp20252963

Keywords:

Kangaroo mother care, Low birth weight, Plan do study act, Quality improvement

Abstract

Background: Kangaroo mother care (KMC) is an evidence-based neonatal care that resulted in decreased mortality and morbidity in preterm infants. The objective of this study was to improve the duration of KMC for Low Birth Weight (LBW) neonates using a Quality Improvement (QI) methodology.

Methods: This hospital-based study was carried out among eligible low birth weight neonate-mother dyad at the Neonatal Unit of Baba Raghav Das Medical College, Gorakhpur, Uttar Pradesh, India. Quality Improvement methodology was used, which included counseling and sensitization of staff nurse and family members about KMC, reward and positive reinforcement of staff nurse and family members and implementation of a written hospital policy. The effect of KMC was assessed by duration of KMC in three Plan-do-study-act (PDSA) cycles, each of 3 months duration. Data was analyzed by using SPSS.

Results: The total duration of KMC was increased from 6.28 hours/day during PDSA-1cycle to12.13 hours/day during PDSA-3 cycle.

Conclusions: By applying QI methodology with existing infrastructure and staff only, there was improvement in KMC duration in preterm LBW neonates.

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References

World Health Organization. Preterm birth. 2023. Available at: https://www.who.int/news-room/fact-sheets/detail/preterm-birth. Assessed on 5 April 2025.

World Health Organization. Kangaroo mother care: a practical guide. Geneva: WHO. 2003. https://apps.who.int/iris/handle/10665/42587. Accessed 5 April 2024.

Kurt FY, Kucukoglu S, Ozdemir AA, Ozcan Z. The effect of kangaroo care on maternal attachment in preterm infants. Niger J Clin Pract. 2020;23(1):26-32. DOI: https://doi.org/10.4103/njcp.njcp_143_18

Hunt F. The importance of kangaroo care on infant oxygen saturation levels and bonding. J Neonat Nurs. 2008;1;14(2):47-51. DOI: https://doi.org/10.1016/j.jnn.2007.12.003

Maria A, Shukla A, Wadhwa R, Kaur B, Sarkar B, Kaur M. Achieving early mother-baby skin-to-skin contact in caesarean section: A quality improvement initiative. Indian Pediat. 2018;55:765-7. DOI: https://doi.org/10.1007/s13312-018-1377-2

Linnér A, Westrup B, Lode-Kolz K, Klemming S, Lillieskold S, Markhus Pike H, et al. Immediate parent-infant skin-to-skin study (IPISTOSS): study protocol of a randomized controlled trial on very preterm infants cared for in skin-to-skin contact immediately after birth and potential physiological, epigenetic, psychological and neurodevelopmental consequences. BMJ Open. 2020;10(7):38938. DOI: https://doi.org/10.1136/bmjopen-2020-038938

Deng Q, Li Q, Wang H, Sun H, Xu X. Early father-infant skin-to-skin contact and its effect on the neurodevelopmental outcomes of moderately preterm infants in China: study protocol for a randomized controlled trial. Trials. 2018;19(1):701. DOI: https://doi.org/10.1186/s13063-018-3060-2

Worku B, Kassie A. Kangaroo mother care: a randomized controlled trial on effectiveness of early kangaroo mother care for the low birthweight infants in Addis Ababa, Ethiopia. J Trop Pediatr. 2005;51(2):93-7. DOI: https://doi.org/10.1093/tropej/fmh085

Arya S, Naburi H, Kawaza K, Newton S, Anyabolu CH, Bergman, et al. WHO Immediate KMC Study Group. Immediate "Kangaroo Mother Care" and survival of infants with low birth weight. N Engl J Med. 2021;384(21):2028-38. DOI: https://doi.org/10.1056/NEJMoa2026486

Cattaneo A, Davanzo R, Worku B, Surjono A, Echeverria M, Bedri A, et al. Kangaroo mother care for low birthweight infants: a randomised controlled trial in different settings. Acta Paediatrica, 1998;87:976-85. DOI: https://doi.org/10.1080/080352598750031653

Gebeyehu NA, Gelaw KA, Azeze GA, Admass BA, Lake EA, Adela GA. Knowledge, attitude and practice towards kangaroo mother care among postnatal women in Ethiopia: systematic review and meta-analysis. PLoS One. 2022;17(5):265411. DOI: https://doi.org/10.1371/journal.pone.0265411

Jegannathan S, Natarajan M, Solaiappan M, Shanmugam R, Tilwani SA. Quality improvement initiative to improve the duration of Kangaroo Mother Care in tertiary care neonatal unit of South India. BMJ Open Qual. 2022;11(1):1775. DOI: https://doi.org/10.1136/bmjoq-2021-001775

Joshi A, Londhe A, Joshi T, Deshmukh L. Quality improvement in kangaroo mother care: learning from a teaching hospital. BMJ Open Qual. 2022;11(1):1459. DOI: https://doi.org/10.1136/bmjoq-2021-001459

Christine A, Sandra E. Avery’s Diseases of the Newborn. 10th ed. Elsevier. 2018.

Yue J, Liu J, Williams S, Zhang B, Zhao Y, Zhang Q, et al. Barriers and facilitators of kangaroo mother care adoption in five Chinese hospitals: a qualitative study. BMC Public Health. 2020;13;20(1):1234. DOI: https://doi.org/10.1186/s12889-020-09337-6

Jamali QZ, Shah R, Shahid F, Fatima A, Khalsa S, Spacek J, et al. Barriers and enablers for practicing kangaroo mother care (KMC) in rural Sindh, Pakistan. PLoS One. 2019;14(6):213225. DOI: https://doi.org/10.1371/journal.pone.0213225

Seidman G, Unnikrishnan S, Kenny E, Myslinski S, Cairns-Smith S, Mulligan B, et al. Barriers and enablers of kangaroo mother care practice: a systematic review. PLoS One. 2015;10(5):125643. DOI: https://doi.org/10.1371/journal.pone.0125643

Bilal SM, Tadele H, Abebo TA, Tadesse BT, Muleta M, Gebriel F, et al. Barriers for kangaroo mother care (KMC) acceptance and practices in southern Ethiopia: a model for scaling up uptake and adherence using qualitative study. BMC Pregn Childbirth. 2021;21(1):25. DOI: https://doi.org/10.1186/s12884-020-03409-6

Hadush MY, Gebremariam DS, Beyene SA, Abay TH, Berhe AH, Zelelew YB, et al. Barriers and enablers of KMC implementation in health facility and community of Tigray Region, Northern Ethiopia: formative research. Pediatric Health Med Ther. 2022;13:297-307. DOI: https://doi.org/10.2147/PHMT.S369858

Panda SK, Das S, Nayak MK, Rath S, Polakampalli N, Mishra S. Implementation of home-based KMC during SARS-CoV-2 pandemic through a quality-improvement initiative. Perinatology. 2021:159-64.