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Barriers and Enablers of Kangaroo Mother Care Practice: A Systematic Review

Author

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  • Gabriel Seidman
  • Shalini Unnikrishnan
  • Emma Kenny
  • Scott Myslinski
  • Sarah Cairns-Smith
  • Brian Mulligan
  • Cyril Engmann

Abstract

Kangaroo mother care (KMC) is an evidence-based approach to reducing mortality and morbidity in preterm infants. Although KMC is a key intervention package in newborn health initiatives, there is limited systematic information available on the barriers to KMC practice that mothers and other stakeholders face while practicing KMC. This systematic review sought to identify the most frequently reported barriers to KMC practice for mothers, fathers, and health practitioners, as well as the most frequently reported enablers to practice for mothers. We searched nine electronic databases and relevant reference lists for publications reporting barriers or enablers to KMC practice. We identified 1,264 unique publications, of which 103 were included based on pre-specified criteria. Publications were scanned for all barriers / enablers. Each publication was also categorized based on its approach to identification of barriers / enablers, and more weight was assigned to publications which had systematically sought to understand factors influencing KMC practice. Four of the top five ranked barriers to KMC practice for mothers were resource-related: “Issues with the facility environment / resources,” “negative impressions of staff attitudes or interactions with staff,” “lack of help with KMC practice or other obligations,” and “low awareness of KMC / infant health.” Considering only publications from low- and middle-income countries, “pain / fatigue” was ranked higher than when considering all publications. Top enablers to practice were included “mother-infant attachment” and “support from family, friends, and other mentors.” Our findings suggest that mother can understand and enjoy KMC, and it has benefits for mothers, infants, and families. However, continuous KMC may be physically and emotionally difficult, and often requires support from family members, health practitioners, or other mothers. These findings can serve as a starting point for researchers and program implementers looking to improve KMC programs.

Suggested Citation

  • Gabriel Seidman & Shalini Unnikrishnan & Emma Kenny & Scott Myslinski & Sarah Cairns-Smith & Brian Mulligan & Cyril Engmann, 2015. "Barriers and Enablers of Kangaroo Mother Care Practice: A Systematic Review," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-20, May.
  • Handle: RePEc:plo:pone00:0125643
    DOI: 10.1371/journal.pone.0125643
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    References listed on IDEAS

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    1. Alessandro Liberati & Douglas G Altman & Jennifer Tetzlaff & Cynthia Mulrow & Peter C Gøtzsche & John P A Ioannidis & Mike Clarke & P J Devereaux & Jos Kleijnen & David Moher, 2009. "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-28, July.
    2. Ylva Thernström Blomqvist & Kerstin Hedberg Nyqvist, 2011. "Swedish mothers’ experience of continuous Kangaroo Mother Care," Journal of Clinical Nursing, John Wiley & Sons, vol. 20(9‐10), pages 1472-1480, May.
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    1. Delia Cristóbal Cañadas & Tesifón Parrón Carreño & Cristina Sánchez Borja & Antonio Bonillo Perales, 2022. "Benefits of Kangaroo Mother Care on the Physiological Stress Parameters of Preterm Infants and Mothers in Neonatal Intensive Care," IJERPH, MDPI, vol. 19(12), pages 1-15, June.
    2. Ulviye Günay & Didem Coşkun Şimşek, 2021. "Emotions and Experience of Fathers applying Kangaroo Care in the Eastern Anatolia Region of Turkey: A Qualitative Study," Clinical Nursing Research, , vol. 30(6), pages 840-846, July.
    3. Qingqi Deng & Yao Zhang & Qiufang Li & Hua Wang & Xinfen Xu, 2018. "Factors that have an impact on knowledge, attitude and practice related to kangaroo care: National survey study among neonatal nurses," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(21-22), pages 4100-4111, November.

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