Compliance toward key elements of kangaroo mother care and its predictors among postnatal mothers with preterm and/or low birth weight newborns in southern Ethiopia, 2021: A count analysis

Abstract

Background: Although kangaroo mother care has been field-tested and found to be effective for preterm and/or low birth weight newborns at the health facility and community level, implementation and scale-up in low-income countries, including Ethiopia, have proven difficult. There was a dearth of evidence that shows compliance of mothers toward components of the kangaroo mother care.

Objectives: Hence, this study aimed at assessing the compliance of postnatal mothers toward World Health Organization-recommended elements of kangaroo mother care and the factors that influence it in southern Ethiopia, 2021.

Design: A hospital-based cross-sectional study was conducted among 257 mothers with preterm and low birth weight newborns from 1 July to 30 August 2021.

Methods: A pretested, structured, interviewer-administered questionnaire and document review were used to collect data. The practice of kangaroo mother care was considered as a count variable. Analysis of variance and independent t-tests were used to examine the variation in the mean score of kangaroo mother care across covariates, and variables with a p value of 0.05 were eligible for the multivariable generalized linear regression model. The effect of each independent variable on the dependent variable was examined using multivariable generalized linear regression with a negative binomial log link.

Results: The mean (±standard deviation) practice score of kangaroo mother care items was 5.12 (±2.39), with 2 and 10 as the minimum and maximum item scores, respectively. Place of residence (adjusted odds ratio = 1.55; 95% confidence interval:1.33-2.29), mode of delivery (adjusted odds ratio = 1.37; 95% confidence interval: 1.11-2.21), birth preparedness and complication readiness plan (adjusted odds ratio = 1.63; 95% confidence interval:1.32-2.26), maternal knowledge of kangaroo mother care (adjusted odds ratio = 1.40; 95% confidence interval: 1.05-1.87), and place of delivery (adjusted odds ratio = 0.67; 95% confidence interval: 0.48-0.94) were identified as significant predictors of compliance toward key elements of kangaroo mother care.

Conclusion: The overall practice of mothers toward key elements of kangaroo mother care was low in the study area. Health care providers who work in the maternal and child health service delivery points should pay special attention to women who come from rural areas and have had cesarean sections, by encouraging and guiding them to practice kangaroo mother care. Women should be counseled during antenatal care and after delivery to improve their knowledge of kangaroo mother care. Health workers in antenatal care clinics should place a strong emphasis on enhancing birth preparedness and complication readiness plans.

Keywords: Ethiopia; determinants; kangaroo mother care; mothers; neonates.

Figure 1.

Percentages of contents of BPCR practiced by mothers with preterm and LBW in Hadiya Zone, southern Ethiopia, 2021. BPCR: Birth preparedness and complication readiness; LBW: low birth weight.

Figure 2.

Categories of gestational age among preterm births in Hadiya Zone, southern Ethiopia, 2021.

Figure 3.

Percentage of mothers practicing WHO-recommended elements of KMC services in Hadiya Zone, southern Ethiopia, 2021. KMC: kangaroo mother care; WHO: World Health Organization.

Figure 4.

Variation in the number of items of KMC implemented among urban and rural women in Hadiya Zone, southern Ethiopia, 2021. KMC: kangaroo mother care.