Quality of Kangaroo Mother Care services in Ethiopia: Implications for policy and practice

English version

Autoři: Haftom Gebrehiwot Weldearegay ^aff001; Araya Abrha Medhanyie ^aff001; Mulugeta Woldu Abrha ^aff002; Lisanu Tadesse ^aff003; Ephrem Tekle ^aff004; Bereket Yakob ^aff005; Tsinuel Girma ^aff005; Catherine Arsenault ^aff005
Působiště autorů: College of Health Sciences, Mekelle University, Mekelle, Ethiopia ^aff001; Tigray Health Research Institute, Mekelle, Ethiopia ^aff002; JSI, L10K and Federal Ministry of Health, Addis Ababa, Ethiopia ^aff003; Maternal and Child Health Directorate, Federal Ministry of Health, Addis Ababa, Ethiopia ^aff004; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America ^aff005
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0225258

Souhrn

Background

Providing high-quality kangaroo mother care (KMC) is a strategy proven to improve outcomes in premature babies. However, whether KMC is consistently and appropriately provided in Ethiopia is unclear. This study assesses the quality of KMC services in Ethiopia and the factors associated with its appropriate initiation among low birth weight neonates.

Methods

We used data from the 2016 national Emergency Obstetric and Newborn Care (EmONC) assessment which contains data on all health facilities providing delivery care services in Ethiopia (N = 3,804). We described the quality of KMC services provided to low-birth weight (LBW) babies in terms of infrastructure, processes and outcomes (survival status at discharge). We also explored the factors associated with appropriate KMC initiation using multivariable logistic regression models.

Results

The quality of KMC services in Ethiopia was poor. The facilities included scored only 59.0% on average on a basic index of service readiness. KMC was initiated for only 46.4% of all LBW babies included in the sample. Among those who received KMC, 66.7% survived, 13.3% died and 20.4% had no data on survival status at discharge. LBW babies born in health centers were twice more likely to receive KMC compared to those born in hospitals (AOR = 2.0, 95% CI: 1.3–3.0). Public facilities, those with a staff rotation policy in place for newborn care, and those with separate newborn corners were also more likely to initiate KMC for LBW babies.

Conclusions

We found low levels of appropriate KMC initiation, inadequate infrastructure and staffing, and poor survival among LBW babies in Ethiopia. Efforts must be made to improve the adoption of this life saving technique, particularly in hospitals and in the private sector where KMC remains underutilized. Facilities should also dedicate specific spaces for newborn care that enables mothers to provide KMC. In addition, improving record keeping and data quality for routine health data is a priority.

Klíčová slova:

Neonates – Neonatal care – Labor and delivery – Birth weight – Health care policy – Population density – Ethiopia – Charts

Zdroje

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