@article{1f067ac1966c42bcb25fffc99636ee60,
title = "The three waves in implementation of facility-based kangaroo mother care: A multi-country case study from Asia",
abstract = "Background: Kangaroo mother care has been highlighted as an effective intervention package to address high neonatal mortality pertaining to preterm births and low birth weight. However, KMC uptake and service coverage have not progressed well in many countries. The aim of this case study was to understand the institutionalisation processes of facility-based KMC services in three Asian countries (India, Indonesia and the Philippines) and the reasons for the slow uptake of KMC in these countries. Methods: Three main data sources were available: background documents providing insight in the state of implementation of KMC in the three countries; visits to a selection of health facilities to gauge their progress with KMC implementation; and data from interviews and meetings with key stakeholders. Results: The establishment of KMC services at individual facilities began many years before official prioritisation for scale-up. Three major themes were identified: pioneers of facility-based KMC; patterns of KMC knowledge and skills dissemination; and uptake and expansion of KMC services in relation to global trends and national policies. Pioneers of facility-based KMC were introduced to the concept in the 1990s and established the practice in a few individual tertiary or teaching hospitals, without further spread. A training method beneficial to the initial establishment of KMC services in a country was to send institutional health-professional teams to learn abroad, notably in Colombia. Further in-country cascading took place afterwards and still later on KMC was integrated into newborn and obstetric care programs. The patchy uptake and expansion of KMC services took place in three phases aligned with global trends of the time: the pioneer phase with individual champions while the global focus was on child survival (1998-2006); the newborn-care phase (2007-2012); and lastly the current phase where small babies are also included in action plans. Conclusions: This paper illustrates the complexities of implementing a new healthcare intervention. Although preterm care is currently in the limelight, clear and concerted country-led KMC scale-up strategies with associated operational plans and budgets are essential for successful scale-up.",
keywords = "Delivery of health care, Implementation, India, Indonesia, Infant premature, Kangaroo mother care, Neonatal mortality, Newborn health, Philippines",
author = "Bergh, {Anne Marie} and {De Graft-Johnson}, Joseph and Neena Khadka and Alyssa Om'Iniabohs and Rekha Udani and Hadi Pratomo and {De Leon-Mendoza}, Socorro",
note = "Funding Information: This study was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Leader with Associates Cooperative Agreement GHS-A-00-08-00002-00 and Cooperative Agreement AID-OAA-A-14-0028 and Save the Children{\textquoteright}s Saving Newborn Lives program. The World Health Organization Western Pacific Region (WHO-WPRO) contributed to the funding of the Philippines study (Project Reference: 2013/354438-1). The contents are the responsibility of The Maternal and Child Health Integrated Program (MCHIP), The Maternal and Child Survival Program (MCSP) and Saving Newborn Lives, and do not necessarily reflect the views of USAID, the United States Government, the Bill and Melinda Gates Foundation or the WHO-WPRO. The South African Medical Research Council Unit for Maternal and Infant Health Care Strategies at the University of Pretoria was contracted by Save the Children to lead the study. We would like to thank all the participants in this study and acknowledge the following people for facilitation of processes, reviews or other forms of assistance: Dr Suman Rao (St. John{\textquoteright}s Medical College Hospital, Bangalore, India); Dr Howard Sobel (WHO, Western Pacific Regional Office); Rachel Taylor (MCHIP/USAID, Washington, D.C.); Steve Wall, Elaine Scudder and Bina Valsangkar (Saving Newborn Lives, Save the Children, Washington, D.C.); Dr Jacqueline Kitong (WHO, Philippines); Dr Anthony Calibo (Department of Health, Philippines); Ishaprasad Bhagwat and Rajesh Khanna (Save the Children, India); Anju Puri and Pawan Pathak (previously MCHIP/USAID India); Dini Hakim and Pancho Kaslam (Save the Children, Indonesia); Dr Ekawaty Haksari (RSUP Sardjito, Yogyakarta, Indonesia). Funding Information: This study was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Leader with Associates Cooperative Agreement GHS-A-00-08-00002-00 and Cooperative Agreement AID-OAA-A- 14-0028 and Save the Children's Saving Newborn Lives program. The World Health Organization Western Pacific Region (WHO-WPRO) contributed to the funding of the Philippines study (Project Reference: 2013/354438-1). The contents are the responsibility of The Maternal and Child Health Integrated Program (MCHIP), The Maternal and Child Survival Program (MCSP) and Saving Newborn Lives, and do not necessarily reflect the views of USAID, the United States Government, the Bill and Melinda Gates Foundation or the WHO-WPRO. The South African Medical Research Council Unit for Maternal and Infant Health Care Strategies at the University of Pretoria was contracted by Save the Children to lead the study. Publisher Copyright: {\textcopyright} 2016 Bergh et al.",
year = "2016",
month = jan,
day = "27",
doi = "10.1186/s12914-016-0080-4",
language = "English",
volume = "16",
journal = "BMC International Health and Human Rights",
issn = "1472-698X",
publisher = "BioMed Central Ltd.",
number = "1",
}