Implementing the Family-Led Care model for preterm and low birth weight newborns in Malawi: experience of healthcare workers

Background: Every Preemie­SCALE developed and piloted the Family-Led Care model, an innovative, locally developed model of care for preterm and low birth weight babies receiving kangaroo mother care. Aim: The aim of this study was to describe healthcare workers' experience using Family-Led Care. Setting: This study was conducted in five health facilities and their catchment areas in Balaka district, Malawi. Methods: The mixed-methods design, with two data collection periods, included record reviews, observations and questionnaires for facility staff and qualitative interviews with health workers of these facilities and their catchment areas. The total convenience sample comprised 123 health professionals, support staff and non-professional community health workers. Results: Facility-based staff generally had positive perceptions of Family-Led Care (83%). Knowledge and application-of-knowledge scores were 69% and 52%, respectively. A major change between the first and the second data periods was improvement in client record-keeping. Documentation of newborn vital signs increased from 62% to 92%. Themes emerging from the qualitative interview analysis were the following: benefits of Family-Led Care; activities supporting the implementation of Family-Led Care; own care practices; and families' reaction to and experience of Family-Led Care. Conclusion: This article reports improved quality of care through better documentation and better follow-up of preterm and low birth weight babies receiving kangaroo mother care according to the Family-Led Care model. Overall, health workers were positive about their involvement, and they reported positive reactions from families. Lessons learned have been incorporated into a universal Family-Led Care package that is available for adaptation by other countries

Implementation of Kangaroo mother care by health workers in Nigeria

Background: Kangaroo Mother Care (KMC) has been proven to significantly improve growth, reduce mortality and morbidity in low birth weight infants. The impact of KMC in newborn care is expected to be greatest in Africa due to limitations in health care.Objective: The aim of this study was to determine the proportion of Nigerian health workers rendering paediatric care who practice KMC in their institution, and identify some challenges affecting the practice of KMC in Nigerian health institutions.Method: A cross sectional study of the participants at 45th annual scientific conference of the Paediatric Association of Nigeria was conducted.Result: A total of157 respondents 122(77.7%) doctors and 35 (22.3%) nurses were studied. 84 (53.5%) practiced KMC. The reasons for not practicing KMC were lack of policy reported by 43 (58.9%) and inadequate place for the mothers to stay 30(41%).The level of practice was significantly higher among respondents that worked in facilities that care for sick neonates (p = 0.049), have functional incubators (p = 0.014) and practice KMC (p < 0.001.Conclusion: Hospitals should have a written KMC policy and provide KMC wards in order to improve implementation of KMC practice in Nigeria

Utility of Kangaroo Mother Care in Preterm and Low Birthweight Infants

Preterm birth ( 37 completed weeks of gestation) is the largest direct cause of neonatal mortality; accounting for an estimated 27 of the 4-million neonatal deaths every year. Kangaroo mother care (KMC) is a type of care for preterm and premature infants whereby the infant is placed in an upright position against the parent's chest; with early skin-to-skin contact between the parent and infant. Mothers who practise KMC exhibit less maternal stress and fewer symptoms of depression; and have a better sense of the parenting role and more confidence in meeting their babies' needs than those who don't. Despite the apparent feasibility of KMC; currently; only a few preterm babies in low-income countries have access to this intervention. Knowledge of the effectiveness and safety of KMC in the community and home setting; and its effects on growth; is still incomplete. Only one study has examined KMC initiation at home. There is an immense need for the promotion of research to improve the delivery of existing cost-effective interventions in low-resource settings and to address key gaps in knowledge. KMC improves growth in low birthweight and preterm infants; and has a significant role to play in protecting them from hypothermia and sepsis; as well as promoting exclusive breastfeeding. KMC helps to reduce neonatal mortality; and inculcates confidence and a better sense of parenting in mothers with regard to their babies' needs