An evaluation of the effectiveness of skin-to-skin care for low-birth-weight in Egypt

ABSTRACT

Kangaroo Mother Care [KMC] or Skin-to-skin care [SSC] is a universal model of care for preterms. It involves continued skin-to-skin contact between mother and baby for 24 hours a day. Baby is placed in an upright position up on the mother's chest between her breasts and inclined in a position so as to facilitate breastfeeding. It is evidence based medical practice that has been shown to be safe and highly beneficial for the growth and development of babies, in addition to being cost-effective as apposed to incubators and nursing care. It place mothers at the center of care for her baby, enhances recovery and promotes breastfeeding thus reduces the cost of medications and long term complications. However this method is poorly accepted and not implemented in Egypt. Aim: The aim of this study was to assess the knowledge, attitudes and skills [KAS] of health staff with regards KMC; to identify ways to facilitate its introduction in Egypt and to assess the outcome of this intervention on the growth and health states of'infants exposed to this technique of care as compared to traditional care by incubators. Person to person interviews were conducted with 57 physicians and nurses in two neonatal intensive care units [NICUs] in a urban [Cairo University] and 2 regional situated university hospitals [Zagazig and Benha] before and after the intervention. The intervention in the urban university consisted of orientation seminars and on the job training by exposure to a trial of the procedure with 20 mothers-infant pairs. In the intervention unit staff showed a statistically significant improvement in relation to knowledge and attitudes at P<0.05 but not in practice of skills [P>0.05]. Babies exposed to KMC doubled their weights faster, shortened their stay in the NICU and had fewer morbidity problems. KMC is a safe and beneficial technique. Hands-on training of staff, mothers and families can make them more accepting to the technique and promote its implementation in NICUs and in the community