Quality of Kangaroo Mother Care services in Ethiopia: Implications for policy and practice
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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
doi:
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:
Birth weight – Ethiopia – Health care policy – Charts – Labor and delivery – Neonatal care – Neonates – Population density
Zdroje
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PLOS One
2019 Číslo 11
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