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Kangaroo mother care: using formative research to design an acceptable community intervention

BACKGROUND: Low and middle income countries (LMICs), including India, contribute to a major proportion of low birth weight (LBW) infants globally. These infants require special care. Kangaroo Mother Care (KMC) in hospitals is a cost effective and efficacious intervention. In institutional deliveries...

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Autores principales: Mazumder, Sarmila, Upadhyay, Ravi Prakash, Hill, Zelee, Taneja, Sunita, Dube, Brinda, Kaur, Jasmine, Shekhar, Medha, Ghosh, Runa, Bisht, Shruti, Martines, Jose Carlos, Bahl, Rajiv, Sommerfelt, Halvor, Bhandari, Nita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5833044/
https://www.ncbi.nlm.nih.gov/pubmed/29499685
http://dx.doi.org/10.1186/s12889-018-5197-z
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author Mazumder, Sarmila
Upadhyay, Ravi Prakash
Hill, Zelee
Taneja, Sunita
Dube, Brinda
Kaur, Jasmine
Shekhar, Medha
Ghosh, Runa
Bisht, Shruti
Martines, Jose Carlos
Bahl, Rajiv
Sommerfelt, Halvor
Bhandari, Nita
author_facet Mazumder, Sarmila
Upadhyay, Ravi Prakash
Hill, Zelee
Taneja, Sunita
Dube, Brinda
Kaur, Jasmine
Shekhar, Medha
Ghosh, Runa
Bisht, Shruti
Martines, Jose Carlos
Bahl, Rajiv
Sommerfelt, Halvor
Bhandari, Nita
author_sort Mazumder, Sarmila
collection PubMed
description BACKGROUND: Low and middle income countries (LMICs), including India, contribute to a major proportion of low birth weight (LBW) infants globally. These infants require special care. Kangaroo Mother Care (KMC) in hospitals is a cost effective and efficacious intervention. In institutional deliveries, the duration of facility stay is often short. In LMICs, a substantial proportion of deliveries still occur at home and access to health care services is limited. In these circumstances, a pragmatic choice may be to initiate KMC at home for LBW babies. However, evidence is lacking on benefits of community-initiated KMC (cKMC). Promoting KMC at home without an understanding of its acceptability may lead to limited success. METHODS: We conducted formative research to assess the feasibility, acceptability and adoption of cKMC with the aim of designing an intervention package for a randomised controlled trial in LBW infants in Haryana, India. Qualitative methods included 40 in-depth interviews with recently delivered women and 6 focus group discussions, two each with fathers and grandfathers, grandmothers, and community health workers. A prototype intervention package to promote cKMC was developed and tested in 28 mother-infant pairs (of them, one mother had twins), using Household (HH) trials. RESULTS: We found that most mothers in the community recognized that babies born small required special care. In spite of not being aware of the practice of KMC, respondents felt that creating awareness of KMC benefits will promote practice. They expressed concerns about doing KMC for long periods because mothers needed rest after delivery. However, the cultural practice of recently delivered women not expected to be doing household chores and availability of other family members were identified as enablers. HH trials provided an opportunity to test the intervention package and showed high acceptability for KMC. Most mothers perceived benefits such as weight gain and increased activity in the infant. CONCLUSIONS: Community-initiated KMC is acceptable by mothers and adoption rates are high. Formative research is essential for developing a strategy for delivery of an intervention. TRIAL REGISTRATION: Trial registration number CTRI/2015/10/006267. Name of Registry: Clinical Trials Registry - India. URL of Registry: http://ctri.nic.in/Clinicaltrials/login.php Date of Registration: 15/10/2015. Date of enrolment of the first participant to the trial: 18/04/2015.
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spelling pubmed-58330442018-03-05 Kangaroo mother care: using formative research to design an acceptable community intervention Mazumder, Sarmila Upadhyay, Ravi Prakash Hill, Zelee Taneja, Sunita Dube, Brinda Kaur, Jasmine Shekhar, Medha Ghosh, Runa Bisht, Shruti Martines, Jose Carlos Bahl, Rajiv Sommerfelt, Halvor Bhandari, Nita BMC Public Health Research Article BACKGROUND: Low and middle income countries (LMICs), including India, contribute to a major proportion of low birth weight (LBW) infants globally. These infants require special care. Kangaroo Mother Care (KMC) in hospitals is a cost effective and efficacious intervention. In institutional deliveries, the duration of facility stay is often short. In LMICs, a substantial proportion of deliveries still occur at home and access to health care services is limited. In these circumstances, a pragmatic choice may be to initiate KMC at home for LBW babies. However, evidence is lacking on benefits of community-initiated KMC (cKMC). Promoting KMC at home without an understanding of its acceptability may lead to limited success. METHODS: We conducted formative research to assess the feasibility, acceptability and adoption of cKMC with the aim of designing an intervention package for a randomised controlled trial in LBW infants in Haryana, India. Qualitative methods included 40 in-depth interviews with recently delivered women and 6 focus group discussions, two each with fathers and grandfathers, grandmothers, and community health workers. A prototype intervention package to promote cKMC was developed and tested in 28 mother-infant pairs (of them, one mother had twins), using Household (HH) trials. RESULTS: We found that most mothers in the community recognized that babies born small required special care. In spite of not being aware of the practice of KMC, respondents felt that creating awareness of KMC benefits will promote practice. They expressed concerns about doing KMC for long periods because mothers needed rest after delivery. However, the cultural practice of recently delivered women not expected to be doing household chores and availability of other family members were identified as enablers. HH trials provided an opportunity to test the intervention package and showed high acceptability for KMC. Most mothers perceived benefits such as weight gain and increased activity in the infant. CONCLUSIONS: Community-initiated KMC is acceptable by mothers and adoption rates are high. Formative research is essential for developing a strategy for delivery of an intervention. TRIAL REGISTRATION: Trial registration number CTRI/2015/10/006267. Name of Registry: Clinical Trials Registry - India. URL of Registry: http://ctri.nic.in/Clinicaltrials/login.php Date of Registration: 15/10/2015. Date of enrolment of the first participant to the trial: 18/04/2015. BioMed Central 2018-03-02 /pmc/articles/PMC5833044/ /pubmed/29499685 http://dx.doi.org/10.1186/s12889-018-5197-z Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Mazumder, Sarmila
Upadhyay, Ravi Prakash
Hill, Zelee
Taneja, Sunita
Dube, Brinda
Kaur, Jasmine
Shekhar, Medha
Ghosh, Runa
Bisht, Shruti
Martines, Jose Carlos
Bahl, Rajiv
Sommerfelt, Halvor
Bhandari, Nita
Kangaroo mother care: using formative research to design an acceptable community intervention
title Kangaroo mother care: using formative research to design an acceptable community intervention
title_full Kangaroo mother care: using formative research to design an acceptable community intervention
title_fullStr Kangaroo mother care: using formative research to design an acceptable community intervention
title_full_unstemmed Kangaroo mother care: using formative research to design an acceptable community intervention
title_short Kangaroo mother care: using formative research to design an acceptable community intervention
title_sort kangaroo mother care: using formative research to design an acceptable community intervention
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5833044/
https://www.ncbi.nlm.nih.gov/pubmed/29499685
http://dx.doi.org/10.1186/s12889-018-5197-z
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