16 research outputs found
Neonatal nurses's role in kangaroo mother care
No abstract available.http://www.pntonline.co.za/index.php/PN
The effect of formal, neonatal communication-intervention training on mothers in kangaroo care
BACKGROUND: Due to low-birth-weight, preterm birth, HIV and/or AIDS and poverty-related factors, South Africa presents with an increased prevalence of infants at risk of language delay. A Kangaroo Mother Care (KMC) unit offers unique opportunities for training.
AIM: The aim of the present study was to determine if formal, neonatal communication-intervention training had an effect on mothers' knowledge and communication interaction with their high-risk infants.
METHODS: Three groups of mothers participated: Group 1 was trained whilst practicing KMC; Group 2 was not trained but practiced KMC; and Group 3 was also not trained but practiced sporadic KMC. Ten mothers per group were matched for age, education level and birth order of their infants. The individual training was based on graded sensory stimulation and responsive mother-infant communication interaction, which emphasised talking and singing by the mother.
RESULTS: Significant differences were found in mother-infant communication interaction between all three groups, which indicated a positive effect on Group 1 with training. Group 2, KMC without training, also had a positive effect on interaction. However, Group 1 mothers with training demonstrated better knowledge of their infants and were more responsive during interaction than the other two groups.
CONCLUSION: The present study suggests that neonatal communication-intervention training adds value to a KMC programme.http://www.phcfm.orgtm201
Taking kangaroo mother care forward in South Africa : the role of district clinical specialist teams
The global agenda for improved neonatal care includes the scale-up of kangaroo mother care (KMC) services. The establishment of district
clinical specialist teams (DCSTs) in South Africa (SA) provides an excellent opportunity to enhance neonatal care at district level and ensure
translation of policies, including the requirement for KMC implementation, into everyday clinical practice. Tshwane District in Gauteng
Province, SA, has been experiencing an increasing strain on obstetric and neonatal services at central, tertiary and regional hospitals in
recent years as a result of growing population numbers and rapid up-referral of patients, with limited down-referral of low-risk patients to
district-level services. We describe a successful multidisciplinary quality improvement initiative under the leadership of the Tshwane DCST,
in conjunction with experienced local KMC implementers, aimed at expanding the district’s KMC services. The project subsequently served
as a platform for improvement of other areas of neonatal care by means of a systematic approach.http://www.samj.org.zaam2016Paediatrics and Child Healt
Taking kangaroo mother care forward in South Africa: The role of district clinical specialist teams
The global agenda for improved neonatal care includes the scale-up of kangaroo mother care (KMC) services. The establishment of district clinical specialist teams (DCSTs) in South Africa (SA) provides an excellent opportunity to enhance neonatal care at district level and ensure translation of policies, including the requirement for KMC implementation, into everyday clinical practice. Tshwane District in Gauteng Province, SA, has been experiencing an increasing strain on obstetric and neonatal services at central, tertiary and regional hospitals in recent years as a result of growing population numbers and rapid up-referral of patients, with limited down-referral of low-risk patients to district-level services. We describe a successful multidisciplinary quality improvement initiative under the leadership of the Tshwane DCST, in conjunction with experienced local KMC implementers, aimed at expanding the district’s KMC services. The project subsequently served as a platform for improvement of other areas of neonatal care by means of a systematic approach
Scaling up kangaroo mother care in South Africa: 'on-site' versus 'off-site' educational facilitation
Background Scaling up the implementation of new health care interventions can be challenging and demand intensive training or retraining of health workers. This paper reports on the results of testing the effectiveness of two different kinds of face-to-face facilitation used in conjunction with a well-designed educational package in the scaling up of kangaroo mother care. Methods : Thirty-six hospitals in the Provinces of Gauteng and Mpumalanga in South Africa were targeted to implement kangaroo mother care and participated in the trial. The hospitals were paired with respect to their geographical location and annual number of births. One hospital in each pair was randomly allocated to receive either 'on-site' facilitation (Group A) or 'off-site' facilitation (Group B). Hospitals in Group A received two on-site visits, whereas delegates from hospitals in Group B attended one off-site, 'hands-on' workshop at a training hospital. All hospitals were evaluated during a site visit six to eight months after attending an introductory workshop and were scored by means of an existing progress-monitoring tool with a scoring scale of 0-30. Successful implementation was regarded as demonstrating evidence of practice (score >10) during the site visit. Results : There was no significant difference between the scores of Groups A and B (p = 0.633). Fifteen hospitals in Group A and 16 in Group B demonstrated evidence of practice. The median score for Group A was 16.52 (range 00.00-23.79) and that for Group B 14.76 (range 07.50-23.29). Conclusion : A previous trial illustrated that the implementation of a new health care intervention could be scaled up by using a carefully designed educational package, combined with face-to-face facilitation by respected resource persons. This study demonstrated that the site of facilitation, either on site or at a centre of excellence, did not influence the ability of a hospital to implement KMC. The choice of outreach strategy should be guided by local circumstances, cost and the availability of skilled facilitators
Progress with the implementation of kangaroo mother care in four regions in Ghana
AIM : To measure progress with the implementation of
kangaroo mother care (KMC) for low birth-weight
(LBW) infants at a health systems level.
DESIGN : Action research design, with district and regional
hospitals as the unit of analysis.
SETTING : Four regions in Ghana, identified by the Ghana
Health Service and UNICEF.
PARTICIPANTS : Health workers and officials, health care
facilities and districts in the four regions.
INTERVENTION : A one-year implementation programme
with three phases: (1) introduction to KMC, skills development
in KMC practice and the management of
implementation; (2) advanced skills development for
regional steering committee members; and (3) an assessment
of progress at the end of the intervention.
MAIN OUTCOME MEASURES : Description of practices,
services and facilities for KMC and the identification
of strengths and challenges.
RESULTS : Twenty-six of 38 hospitals (68%) demonstrated
sufficient progress with KMC implementation. Half
of the hospitals had designated a special ward for
KMC. 66% of hospitals used a special record for infants
receiving KMC. Two of the main challenges were
lack of support for mothers who had to remain with
their LBW infants in hospital and no follow-up review
services for LBW infants in 39% of hospitals.
CONCLUSIONS : It was possible to roll out KMC in Ghana,
but further support for the regions is needed to maintain the momentum. Lessons learned from this
project could inform further scale-up of KMC and other
projects in Ghana.The United
Nations Children’s Fundhttp://www.ghanamedj.orgam2017Paediatrics and Child Healt
Translating research findings into practice – the implementation of kangaroo mother care in Ghana
BACKGROUND: Kangaroo mother care (KMC) is a safe and effective method of caring for low birth weight infants
and is promoted for its potential to improve newborn survival. Many countries find it difficult to take KMC to scale
in healthcare facilities providing newborn care. KMC Ghana was an initiative to scale up KMC in four regions in
Ghana. Research findings from two outreach trials in South Africa informed the design of the initiative. Two key
points of departure were to equip healthcare facilities that conduct deliveries with the necessary skills for KMC
practice and to single out KMC for special attention instead of embedding it in other newborn care initiatives.
This paper describes the contextualisation and practical application of previous research findings and the results of
monitoring the progress of the implementation of KMC in Ghana.
METHODS: A three-phase outreach intervention was adapted from previous research findings to suit the local
setting. A more structured system of KMC regional steering committees was introduced to drive the process and
take the initiative forward. During Phase I, health workers in regions and districts were oriented in KMC and
received basic support for the management of the outreach. Phase II entailed the strengthening of the regional
steering committees. Phase III comprised a more formal assessment, utilising a previously validated KMC
progress-monitoring instrument.
RESULTS: Twenty-six out of 38 hospitals (68 %) scored over 10 out of 30 and had reached the level of ‘evidence of
practice’ by the end of Phase III. Seven hospitals exceeded expected performance by scoring at the level of
‘evidence of routine and institutionalised practice.’ The collective mean score for all participating hospitals was
12.07. Hospitals that had attained baby-friendly status or had been re-accredited in the five years before the
intervention scored significantly better than the rest, with a mean score of 14.64.
CONCLUSION: The KMC Ghana initiative demonstrated how research findings regarding successful outreach for the
implementation of KMC could be transferred to a different context by making context-appropriate adaptations to
the model.The United Nations Children’s Fundhttp://www.implementationscience.com/content/7/1/7
Implementing facility-based kangaroo mother care services : lessons from a multi-country study in Africa
BACKGROUND : Some countries have undertaken programs that included scaling up kangaroo mother care. The aim
of this study was to systematically evaluate the implementation status of facility-based kangaroo mother care
services in four African countries: Malawi, Mali, Rwanda and Uganda.
METHODS : A cross-sectional, mixed-method research design was used. Stakeholders provided background information at
national meetings and in individual interviews. Facilities were assessed by means of a standardized tool previously applied
in other settings, employing semi-structured key-informant interviews and observations in 39 health care facilities in the
four countries. Each facility received a score out of a total of 30 according to six stages of implementation progress.
RESULTS : Across the four countries 95 per cent of health facilities assessed demonstrated some evidence of kangaroo
mother care practice. Institutions that fared better had a longer history of kangaroo mother care implementation or had
been developed as centres of excellence or had strong leaders championing the implementation process. Variation existed
in the quality of implementation between facilities and across countries. Important factors identified in implementation are:
training and orientation; supportive supervision; integrating kangaroo mother care into quality improvement; continuity of
care; high-level buy in and support for kangaroo mother care implementation; and client-oriented care.
CONCLUSION : The integration of kangaroo mother care into routine newborn care services should be part of all maternal
and newborn care initiatives and packages. Engaging ministries of health and other implementing partners from the
outset may promote buy in and assist with the mobilization of resources for scaling up kangaroo mother care services.
Mechanisms for monitoring these services should be integrated into existing health management information systems.http://www.biomedcentral.com/bmchealthservreshb201
The effect of formal, neonatal communication-intervention training on mothers in kangaroo care
Background: Due to low-birth-weight, preterm birth, HIV and/or AIDS and poverty-related factors, South Africa presents with an increased prevalence of infants at risk of language delay. A Kangaroo Mother Care (KMC) unit offers unique opportunities for training.
Aim: The aim of the present study was to determine if formal, neonatal communication-intervention training had an effect on mothers’ knowledge and communication interaction with their high-risk infants.
Methods: Three groups of mothers participated: Group 1 was trained whilst practicing KMC; Group 2 was not trained but practiced KMC; and Group 3 was also not trained but practiced sporadic KMC. Ten mothers per group were matched for age, education level and birth order of their infants. The individual training was based on graded sensory stimulation and responsive mother-infant communication interaction, which emphasised talking and singing by the mother.
Results: Significant differences were found in mother-infant communication interaction between all three groups, which indicated a positive effect on Group 1 with training. Group 2, KMC without training, also had a positive effect on interaction. However, Group 1 mothers with training demonstrated better knowledge of their infants and were more responsive during interaction than the other two groups.
Conclusion: The present study suggests that neonatal communication-intervention training adds value to a KMC programme