The three waves in implementation of facility-based kangaroo mother care: a multi-country case study from Asia

BMC International Health and Human Rights

Research Article

Socorro De Leon-Mendoza¹  Rekha Udani²  Hadi Pratomo³  Anne-Marie Bergh⁴  Alyssa Om’Iniabohs⁵  Neena Khadka⁵  Joseph de Graft-Johnson⁶ 

[1] Bless-Tetada Kangaroo Mother Care Foundation Phil., Inc., 7431 P. Burgos Street, San Dionisio Paranaque City Metro, Manila, Philippines;D Y Patil University, School of Medicine, Nerul, Navi Mumbai, India;Faculty of Public Health, Universitas Indonesia, Depok Campus, Depok 16424, West Java, Indonesia;MRC Unit for Maternal and Infant Health Care Strategies, University of Pretoria, Pretoria, South Africa;Maternal and Child Survival Program, 1776 Massachusetts Avenue, NW, Suite 300, 20036, Washington, DC, USA;Save the Children, 2000 L Street NW, Suite 500, 20036, Washington, DC, USA;

关键词: Delivery of health care;    Implementation;    Infant premature;    Kangaroo mother care;    Neonatal mortality;    Newborn health;    India;    Indonesia;    Philippines;   

DOI  :  10.1186/s12914-016-0080-4

 received in 2015-09-09, accepted in 2016-01-22,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundKangaroo mother care has been highlighted as an effective intervention package to address high neonatal mortality pertaining to preterm births and low birth weight. However, KMC uptake and service coverage have not progressed well in many countries. The aim of this case study was to understand the institutionalisation processes of facility-based KMC services in three Asian countries (India, Indonesia and the Philippines) and the reasons for the slow uptake of KMC in these countries.MethodsThree main data sources were available: background documents providing insight in the state of implementation of KMC in the three countries; visits to a selection of health facilities to gauge their progress with KMC implementation; and data from interviews and meetings with key stakeholders.ResultsThe establishment of KMC services at individual facilities began many years before official prioritisation for scale-up. Three major themes were identified: pioneers of facility-based KMC; patterns of KMC knowledge and skills dissemination; and uptake and expansion of KMC services in relation to global trends and national policies.Pioneers of facility-based KMC were introduced to the concept in the 1990s and established the practice in a few individual tertiary or teaching hospitals, without further spread. A training method beneficial to the initial establishment of KMC services in a country was to send institutional health-professional teams to learn abroad, notably in Colombia. Further in-country cascading took place afterwards and still later on KMC was integrated into newborn and obstetric care programs.The patchy uptake and expansion of KMC services took place in three phases aligned with global trends of the time: the pioneer phase with individual champions while the global focus was on child survival (1998–2006); the newborn-care phase (2007–2012); and lastly the current phase where small babies are also included in action plans.ConclusionsThis paper illustrates the complexities of implementing a new healthcare intervention. Although preterm care is currently in the limelight, clear and concerted country-led KMC scale-up strategies with associated operational plans and budgets are essential for successful scale-up.

【 授权许可】

CC BY   
© Bergh et al. 2016