Mothers to preterms: “We appreciate kangaroo care but we are overwhelmed”
It is mid-morning on this week day at Bugiri Hospital. The table in the hospital’s boardroom is almost encircled with mothers carrying babies ranging from newborns to a few weeks old. The mothers are here to attend a focus group discussion to discuss the facilitators and barriers to kangaroo mother care.
“We are usually in pain. It becomes hard to practice Kangaroo Care especially when you have delivered by C-Section,” says a participant before another chips in adding that “Many times we are alone at home. You have a lot of work to do yet everything will not come to a standstill if I concentrate on KMC.”
The moderator asks whether their spouses can’t help and he’s met with the question: “Do you expect a man to put his work on hold and put the kid in his chest? He will ask you whether he should look for food and carry the kid for you as well.”
This FGD is part of the bigger study titled “Kangaroo Mother Care in Eastern Uganda: Assessing the Factors Influencing Uptake, Adherence and Acceptability into Routine Healthcare and Community Practice.”
The views of the mothers at Bugiri are no different from what is emerging at other sites where study team has interacted with mothers on the same subject matter.
Worth noting from the preliminary findings of the study is that care for preterms varies, according to the Study Team Leader Ms Doris Kwesiga. She says that while in the hospital care is basically through KMC and the use of incubators, it is a different case once the mothers are discharged.
“Some mothers confess to using a mix of medical approaches like KMC as well as the “locally” used charcoal stoves and bottles of hot water as part of the process of keeping the babies warm, yet they have been taught about KMC,” says Ms Kwesiga arguing that this could be a pointer to a knowledge gap
The preliminary findings further show that the way the mothers practice KMC while still in hospital, under supervision, is not the same way once at home, where they also have other duties. They tend to do it less frequently at home.
Uganda has a high preterm birth rate of approximately 14%, with 226,000 babies born prematurely each year. Preterm births contribute greatly to Uganda’s high neonatal mortality, with resultant complications responsible for 38% of neonatal deaths in 2010. Kangaroo Mother Care (KMC) is a low cost intervention that involves continuous skin-to-skin contact between the mother and baby; early and exclusive breastfeeding; early discharge and follow up; and recognition of danger signs and referral. Studies have shown its effectiveness, for instance a systematic review reported that KMC lowered the risk of death among newborns by 40% at discharge or 40-41 weeks. However, its adoption has been limited in Uganda, with KMC only reportedly available in Kampala and four regions in the centre and southwest in 2012.