An exploration of the support received by mothers for kangaroo mother care practice along the health facility-community continuum in a sub-district of Northern Karnataka, India

TL;DR

This study examines how much support mothers receive for kangaroo mother care (KMC) in a region of India and how it affects their practice of this important care method.

Contribution

The study provides new insights into the factors influencing KMC support and practice among mothers in a specific Indian sub-district.

Findings

Most babies were initiated on KMC at the health facility, but support scores for KMC initiation and maintenance were low.

First-time mothers and those with better KMC knowledge received significantly more support for KMC initiation.

Mothers of lower birth weight babies received more support for KMC maintenance.

Abstract

Early initiation with optimal duration of Kangaroo Mother Care (KMC), for all stable small babies (<2000grams at birth), is essential for accelerated reduction of neonatal mortality. The purpose of this paper is to explore the support received by mothers along the health facility-community continuum and its association with KMC practice.

All live small babies aged >  4 weeks of life, who were residing in the Gangawati sub-district, were recruited on a rolling basis (Dec 2017-Sept 2018) to obtain the estimated sample size of 210. Mother-baby dyads were visited in their homes to collect information [knowledge, attitude, and support received] for KMC initiation and maintenance till required. Secondary data on KMC duration was obtained from the district-wide project database.

A total of 209 mothers with 227 small babies were interviewed (18 had twins). The mothers had a mean age of 23 (±4) years; and 7(±5) years of education, with 5 (±2) family members >  18 years in their households. More than half (51%) of the babies were female with a mean age of 35.6 (±7.5)days/ 4-6weeks and mean birth weight of 1693.6 (±221.4)grams irrespective of gestational age; 21.6% of whom were ≤ 1500g at birth. Most of the babies 205 (90.3%) were initiated on KMC at the health facility. The score obtained for KMC initiation [45%} and KMC maintenance support at the health facility [51.3%] was minimal. Multiple regression linear analysis showed that overall KMC support at the health facility was significantly higher for first-time mothers [β coefficient -1.54 (95% CI -2.87, -0.22)] and better knowledge scores on KMC [β coefficient 0.21 (05% CI 0.01, 0.42)]. KMC maintenance support was significantly higher for first-time mothers [β coeff -3.62 (95% CI -6.29, -0.96)] and for mothers whose babies had lower birth weights [β coeff -4.27 (95% CI -7.50, -1.05)].

Mothers require support to initiate and continue KMC along the health facility-community continuum (S1 Table). The role of support at home would require further exploration to determine its association with KMC practice.

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