1
|
Nimbalkar S, Dave H, Budh H, Morgaonkar V, Patel D. Post-discharge home kangaroo mother care follow-up study in rural Gujarat. J Family Med Prim Care 2024; 13:1379-1383. [PMID: 38827680 PMCID: PMC11141989 DOI: 10.4103/jfmpc.jfmpc_1465_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/03/2023] [Accepted: 12/06/2023] [Indexed: 06/04/2024] Open
Abstract
Background Continuation of kangaroo mother care (KMC) at home is vital for improved infant survival and development. Hence, it is essential to understand potential enablers and barriers to home KMC provision. Methodology This observational study was conducted in rural Gujarat. KMC was initiated for all low-birth-weight (LBW) neonates during the hospital stay and were advised to continue home KMC on discharge. The mothers of these LBW neonates were interviewed using a structured questionnaire during follow-up visits or via telephone. Results A total of 100 mothers were interviewed, and 98 practiced home KMC. Mothers' mean age was 24.41 (±3.1) years, and infants' mean age was 3.48 (±1.81) months. The mean weight of neonates at discharge was 1.85 (±0.28) kg. Out of the 104 neonates (96 singleton pregnancies and four twins), 76 (73.07%) were pre-term. 31% mothers provided 4-6 hours of daily KMC. 60% provided KMC for less than 1 hour during each session, while 36% of mothers provided each KMC session for 1-3 hours. 74% of mothers received family support, and 62% faced difficulties in home KMC provision. 88% of mothers were homemakers, and 53% had other children to care for. 51% mothers pre-maturely discontinued KMC provision. 83% of the mothers reported fatigue or pain during KMC provision. Conclusion Lack of family support, other household responsibilities, and other children to care for were major barriers leading to pre-mature discontinuation of home KMC.
Collapse
Affiliation(s)
- Somashekhar Nimbalkar
- Department of Neonatology, Pramukhswami Medical College, Bhaikaka University, Karamsad, Gujarat, India
| | - Hemal Dave
- Department of Pediatrics, Parul Institute of Medical Sciences and Research, Faculty of Medicine, Parul University, Vadodara, Gujarat, India
| | - Hetal Budh
- Department of Neonatology, Pramukhswami Medical College, Bhaikaka University, Karamsad, Gujarat, India
| | - Vallaree Morgaonkar
- Department of Neonatology, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India
| | - Dipen Patel
- Department of Neonatology, Pramukhswami Medical College, Bhaikaka University, Karamsad, Gujarat, India
| |
Collapse
|
2
|
Kadio K, Filippi V, Congo M, Scorgie F, Roos N, Lusambili A, Nakstad B, Kovats S, Kouanda S. Extreme heat, pregnancy and women's well-being in Burkina Faso: an ethnographical study. BMJ Glob Health 2024; 8:e014230. [PMID: 38382997 PMCID: PMC10897842 DOI: 10.1136/bmjgh-2023-014230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/14/2024] [Indexed: 02/23/2024] Open
Abstract
Climate change is an increasing threat to the health of populations in Africa, with a shift in seasonal temperatures towards more extreme heat exposures. In Burkina Faso, like other countries in the Sahel, many women have little protection against exposure to high temperatures, either outside or inside the home or place of work. This paper investigates how women perceive the impacts of heat on their physical and mental health, in addition to their social relationships and economic activities. Qualitative methods (in-depth interviews and focus group discussions) were conducted with women, community representatives and healthcare professionals in two regions in Burkina Faso. A thematic analysis was used to explore the realities of participants' experiences and contextual perspectives in relation to heat. Our research shows extreme temperatures have a multifaceted impact on pregnant women, mothers and newborns. Extreme heat affects women's functionality and well-being. Heat undermines a woman's ability to care for themselves and their child and interferes negatively with breast feeding. Heat negatively affects their ability to work and to maintain harmonious relationships with their partners and families. Cultural practices such as a taboo on taking the baby outside before the 40th day may exacerbate some of the negative consequences of heat. Most women do not recognise heat stress symptoms and lack awareness of heat risks to health. There is a need to develop public health messages to reduce the impacts of heat on health in Burkina Faso. Programmes and policies are needed to strengthen the ability of health professionals to communicate with women about best practices in heat risk management.
Collapse
Affiliation(s)
- Kadidiatou Kadio
- Centre national de la recherche scientifique et technologique (CNRST), Institut de Recherche en Sciences de la Santé, Ouagadougou, Centre, Burkina Faso
| | | | - Mariam Congo
- Centre national de la recherche scientifique et technologique (CNRST), Institut de Recherche en Sciences de la Santé, Ouagadougou, Centre, Burkina Faso
| | - Fiona Scorgie
- Wits Reproductive Health Institute (WRHI), University of the Witwatersrand, Johannesburg, South Africa
| | - Nathalie Roos
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Britt Nakstad
- University of Oslo, Oslo, Norway
- Department of Pediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana
| | - Sari Kovats
- London School of Hygiene & Tropical Medicine, London, UK
| | - Seni Kouanda
- Centre national de la recherche scientifique et technologique (CNRST), Institut de Recherche en Sciences de la Santé, Ouagadougou, Centre, Burkina Faso
| |
Collapse
|
3
|
Li L, Ji F, Wang Y, Wang L, Yu L, Wu X, Lyu T, Dou Y, Cao Y, Hu XJ. The clinical experience of early skin-to-skin contact combined with non-nutritive comfort sucking in mothers of preterm infants: a qualitative study. BMC Pregnancy Childbirth 2023; 23:281. [PMID: 37095429 PMCID: PMC10123578 DOI: 10.1186/s12884-023-05581-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 04/07/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND In most areas of China, mothers typically do not participate in early care of preterm infants in NICU. This study aims to examine the early experience of mothers of preterm infants participating in skin-to-skin contact combined with non-nutritive comfort sucking in China. METHODS This qualitative research study used one-on-one, face-to-face, semi-structured in-depth interviews. Eighteen mothers who participated in early skin-to-skin contact combined with non-nutritive comfort sucking were interviewed in the NICU of a tertiary children's hospital in Shanghai between July and December 2020. Their experiences were analyzed using the inductive topic analysis method. RESULTS Five themes about skin-to-skin contact combined with non-nutritive comfort sucking were identified, including alleviation of maternal anxiety and fear during mother infant separation, reshaping the maternal role, promotion of active breast pumping, enhances the mother's willingness to actively breast feed and building the maternal confidence in baby care. CONCLUSION Skin-to-skin contact combined with non-nutritive comfort sucking in the NICU can not only enhance the identity and responsibility of the mother's role, but also provide non-nutritive sucking experience for promoting the establishment of oral feeding in preterm infants.
Collapse
Affiliation(s)
- Liling Li
- Children's Hospital of Fudan University, the National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China
| | - Futing Ji
- Children's Hospital of Fudan University, the National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China
| | - Yuejue Wang
- Children's Hospital of Fudan University, the National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China
| | - Li Wang
- Children's Hospital of Fudan University, the National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China
| | - Ling Yu
- Children's Hospital of Fudan University, the National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China
| | - Xi Wu
- Children's Hospital of Fudan University, the National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China
| | - Tianchan Lyu
- Children's Hospital of Fudan University, the National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China
| | - Yalan Dou
- Children's Hospital of Fudan University, the National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China
| | - Yun Cao
- Children's Hospital of Fudan University, the National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China
| | - Xiao-Jing Hu
- Children's Hospital of Fudan University, the National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China.
- Research Unit of Early Intervention of Genetically Related Childhood Cardiovascular Diseases(2018RU002), Chinese Academy of Medical Sciences , Beijing, China.
| |
Collapse
|
4
|
Li Y, Hu Y, Chen Q, Li X, Tang J, Xu T, Feng Z, Mu D. Clinical practice guideline for kangaroo mother care in preterm and low birth weight infants. J Evid Based Med 2022; 15:408-424. [PMID: 36529837 DOI: 10.1111/jebm.12509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022]
Abstract
Kangaroo mother care has reduced mortality and morbidity in preterm and low birth weight infants and has many benefits, such as promoting breastfeeding. Based on the current evidence in China and international, we developed a clinical practice guideline for kangaroo mother care in preterm and low birth weight infants using the Grading of Recommendations, Assessment, Development and Evaluation and proposed 34 recommendations for 20 key questions. Our goal is to promote the appropriate implementation of kangaroo mother care in clinical practice.
Collapse
Affiliation(s)
- Yingxin Li
- Department of Neonatology, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, P.R. China
- West China School of Nursing, Sichuan University, Chengdu, P.R. China
| | - Yanlin Hu
- Department of Neonatology, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, P.R. China
- West China School of Nursing, Sichuan University, Chengdu, P.R. China
| | - Qiong Chen
- Department of Neonatology, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, P.R. China
- West China School of Nursing, Sichuan University, Chengdu, P.R. China
| | - Xiaowen Li
- Department of Neonatology, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, P.R. China
- West China School of Nursing, Sichuan University, Chengdu, P.R. China
| | - Jun Tang
- Department of Neonatology, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, P.R. China
| | - Tao Xu
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, P.R. China
| | - Zhichun Feng
- Department of Neonatology, Faculty of Pediatrics, Chinese PLA General Hospital, Beijing, P.R. China
| | - Dezhi Mu
- Department of Neonatology, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, P.R. China
| |
Collapse
|
5
|
Liu X, Chen XH, Li ZK, Cao B, Yue SJ, Liu QY, Yang CZ, Yang CY, Zhao YX, Zhao GL, Feng Q. Implementation experience of a 12-month intervention to introduce intermittent kangaroo mother care to eight Chinese neonatal intensive care units. World J Pediatr 2022; 18:849-853. [PMID: 36006551 PMCID: PMC9617830 DOI: 10.1007/s12519-022-00607-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 08/07/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Xin Liu
- Neonatal Intensive Care Unit, Department of Pediatrics, Peking University First Hospital, Beijing 100034, China
| | - Xiao-Hui Chen
- Department of Neonatology, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Zhan-Kui Li
- Department of Neonatology, Northwest Women's and Children's Hospital, Xi'an, China
| | - Bei Cao
- Department of Neonatology, The Maternal and Child Health Care Hospital of Hunan Province, Changsha, China
| | - Shao-Jie Yue
- Department of Neonatology, Xiangya Hospital Central South University, Changsha, China
| | - Qiong-Yu Liu
- Department of Neonatology, Women & Children's Health Care Hospital of Linyi, Linyi, China
| | - Chuan-Zhong Yang
- Department of Neonatology, Shenzhen Maternity & Child Healthcare Hospital, Shenzhen, China
| | - Chang-Yi Yang
- Department of Neonatology, Fujian Provincial Maternity and Children's Hospital, Fuzhou, China
| | - Ying-Xi Zhao
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Geng-Li Zhao
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Qi Feng
- Neonatal Intensive Care Unit, Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.
| |
Collapse
|
6
|
Hariati S, Sutomo R, McKenna L, Reisenhofer S, Lusmilasari L, Febriani ADB. Indonesian mothers' beliefs on caring practices at home for preterm babies after hospital discharge: A qualitative study. J SPEC PEDIATR NURS 2021; 26:e12330. [PMID: 33773015 DOI: 10.1111/jspn.12330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 02/01/2021] [Accepted: 02/24/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Premature birth may be associated with infant health problems and frequently requires in-hospital and then at-home specialized care. Studies investigating home-caring experiences of mothers of preterm infants in developing countries are limited. This study was to explore preterm mothers' experiences of caring practices at home 1 month after their infant's discharge from a neonatal unit. DESIGN AND METHOD A descriptive qualitative study using in-depth interviews with eight purposively sampled mothers who had been discharged home from neonatal unit in one city in Indonesia. All interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. RESULT Three main themes emerged: (1) transition to independent motherhood, (2) focus on care of infant after discharge, and (3) barriers and enablers for care. The mothers managed their infant care at home by focusing on feeding and managing infant health problems. They faced on myth and culture as one of the barriers. CONCLUSIONS Comprehensive discharge education for mothers of preterm infants and their families is required to enhance mothers' caring abilities and overcome barriers is sufficient. Nurses/midwives need to improve care related to the well-being of mothers and their infants in preparation for, and after, discharge from the neonatal unit.
Collapse
Affiliation(s)
- Suni Hariati
- Pediatric Nursing Department, Faculty of Nursing, Hasanuddin University, Makassar, Indonesia
| | - Retno Sutomo
- Pediatric Department, Faculty of Medicine, Health Sciences and Nursing, Gadjah Mada University, Yogyakarta, Indonesia
| | - Lisa McKenna
- School of Nursing and Midwifery, College of Science Health and Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Sonia Reisenhofer
- College of Science, Health and Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Lely Lusmilasari
- Pediatric Nursing Department, Faculty of Medicine, Health Sciences and Nursing, Gadjah Mada University, Yogyakarta, Indonesia
| | - Andi D B Febriani
- Pediatric Department, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| |
Collapse
|
7
|
Chavula K, Guenther T, Valsangkar B, Lwesha V, Banda G, Bøe Wensaas M, Luhanga R, Chimtembo L, Kinney MV, Dube Q. Improving Skin-to-Skin Practice for babies in Kangaroo Mother Care in Malawi through the use of a customized baby wrap: A randomized control trial. PLoS One 2020; 15:e0229720. [PMID: 32191729 PMCID: PMC7082027 DOI: 10.1371/journal.pone.0229720] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 02/12/2020] [Indexed: 11/18/2022] Open
Abstract
Background Complications of prematurity are a leading cause of newborn death in Malawi. Despite early adoption of Kangaroo mother care (KMC), coverage remains low and women have expressed challenges in using the traditional wrapper–chitenje. In 2016, a study was conducted to evaluate the acceptability and effectiveness of a customized KMC wrap in improving adherence to KMC practices among mothers. Methods Mother-baby dyads (301) were randomized to receive either a customized CarePlus Wrap developed by Lærdal Global Health or a traditional chitenje. Enrolled mother-baby dyads were assessed in the KMC ward at 2–3 days after of admission, and then again at 7–15 days post-discharge. Topics covered included skin-to-skin practices, breastfeeding, perceptions of the wrap, and family/community support. Chi square tests were used to assess associations between wrap type and KMC practices. The study received ethics approval. Results This study found that a customized KMC wrap is highly acceptable to women and improved skin-to-skin practices in facility-based KMC: 44% of mothers using a customized wrap reported 20 or more hours per day, compared to 33% of mothers using the traditional chitenje. Women using the customized wrap reported being comfortable in keeping the baby in skin-to-skin position more often than women using the chitenje (96% vs. 71%), and they were able to tie on the wrap themselves (86% vs. 10%). At the time of discharge from KMC, more women who used the customized wrap were satisfied with the wrap than those who used the traditional chitenje (94% vs. 56%). The customized wrap did not appear to impact other newborn practices, such as breastfeeding. Conclusions This study provides evidence that a customized KMC wrap is highly acceptable to mothers, and it can contribute to better skin-to-skin practices. Use of a customized wrap may be one mechanism to support mothers in practicing KMC and skin-to-skin contact in addition to other interventions.
Collapse
Affiliation(s)
| | - Tanya Guenther
- Department of Global Health, Save the Children US, Washington, DC, United States of America
| | - Bina Valsangkar
- Department of Global Health, Save the Children US, Washington, DC, United States of America
| | | | | | | | | | | | - Mary V Kinney
- Department of Global Health, Save the Children US, Washington, DC, United States of America
| | - Queen Dube
- College of Medicine, University of Malawi, Blantyre, Malawi
| |
Collapse
|
8
|
Thapa K, Mohan D, Williams E, Rai C, Bista S, Mishra S, Hamal PK. Feasibility assessment of an ergonomic baby wrap for kangaroo mother care: A mixed methods study from Nepal. PLoS One 2018; 13:e0207206. [PMID: 30439998 PMCID: PMC6237334 DOI: 10.1371/journal.pone.0207206] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 10/26/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Kangaroo mother care, an evidence based practice and a national policy for management of low birth weight newborns in Nepal, is not widely practiced. This implementation research study aimed to explore the consumer preference and acceptability of the traditional and a new ergonomic wrap on the continuation of kangaroo mother care in the facility and community following discharge. METHODS A mixed method feasibility study was done from May to October 2015. Ninety-six families of stable low birth weight newborns weighing 1800 to 2499 grams were counseled and taught to practice kangaroo mother care using both wraps. They were randomized into two groups of 48 with one group trying out the traditional wrap for the first six hours and the new wrap for the next six, and vice versa. Mothers were allowed to choose between the wraps for continuation of kangaroo mother care at the facility and post discharge. They were followed up telephonically weekly over 28 days postpartum to ascertain practice of kangaroo mother care. In-depth interviews with mothers (n = 12) and focus group discussions with health workers (n = 16) further evaluated the intervention. Descriptive statistics are presented for the quantitative part of the study. RESULTS Mothers in the two groups chose the new wrap with no significant difference (81.3% vs 89.6%, p = 0.24). Of the 96 randomized mothers, 85% chose the new wrap. During the hospital stay, six mothers dropped out and remaining 90 mothers who were discharged with the intention of continuing Kangaroo Mother Care, 78 and 12 mothers did so with the new and traditional wrap respectively. New wrap users (429.1 hours, 95% confidence interval [CI]: 351.7-470.3) performed skin-to-skin contact for an extra 77.4 hours overall than traditional wrap (351.7 hours, 95%CI: 259.3-444) users from first day to 28 day postpartum. Health workers and mothers reported positive experience with the new wrap as it was easy to wear without assistance, secure and flexible to move around in kangaroo mother care position. CONCLUSIONS Involvement of mothers and families with provision of ergonomic wraps showed improvement in kangaroo mother care practice during hospital stay and at home.
Collapse
Affiliation(s)
- Kusum Thapa
- Maternal and Child Survival Program/Jhpiego, Washington, DC, United States of America
| | - Diwakar Mohan
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Emma Williams
- Maternal and Child Survival Program/Jhpiego, Washington, DC, United States of America
| | - Chandra Rai
- Jhpiego/Nepal, Oasis Building, Patan Dhoka, Lalitpur, Kathmandu, Nepal
| | - Sangita Bista
- Jhpiego/Nepal, Oasis Building, Patan Dhoka, Lalitpur, Kathmandu, Nepal
| | | | - Pawan Kumar Hamal
- National Academy of Medical Sciences, National Trauma Center, Kathmandu, Nepal
| |
Collapse
|