Kangaroo Mother Care implementation research to develop models for accelerating scale-up in India and Ethiopia: study protocol for an adequacy evaluation
Introduction Kangaroo Mother Care (KMC) is the practice of early, continuous and prolonged skin-to-skin contact between the mother and the baby with exclusive breastfeeding. Despite clear evidence of impact in improving survival and health outcomes among low birth weight infants, KMC coverage has re...
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| author | Anteneh Asefa Rajiv Bahl Sarmila Mazumder Nita Bhandari Jose Martines Lynn M Sibley Nalini Singhal Khalid Aziz Thomas Brune Araya Abrha Medhanyie Hibret Alemu Selemawit Asfaw Beyene Fisseha Ashebir Gebregizabher Habtamu Beyene Grace Chan John N Cranmer G Darmstadt Dereje Duguma Addisalem Fikre Bizuayehu Gashaw Andualem Abebe Gebremariam Gobezayehu Tedros Hailu Abay H L Mohan Arun Jadaun K Jayanna F N U Kajal Arin Kar Raghav Krishna Aarti Kumar Vishwajeet Kumar Tarun Kumar Madhur Mulusew Lijalem Belew Rajini M Hajira Amin Prem K Mony Mekonnen Muleta Cynthia Pileggi-Castro Suman Pn Rao Abiy Seifu Estifanos Henok Tadele Abraham Tariku Ephrem Tekle Lemango Birkneh Tilahun Tadesse Ravi Upadhyay Bogale Worku Marta Yemane Hadush Grace J Chan Gary Lee Darmstadt HL Mohan Krishnamurthy Jayanna M Rajini Jose Carlos Martines Hajira Mohammed Amin Suman Rao Ravi Prakash Upadhyay |
| author_facet | Anteneh Asefa Rajiv Bahl Sarmila Mazumder Nita Bhandari Jose Martines Lynn M Sibley Nalini Singhal Khalid Aziz Thomas Brune Araya Abrha Medhanyie Hibret Alemu Selemawit Asfaw Beyene Fisseha Ashebir Gebregizabher Habtamu Beyene Grace Chan John N Cranmer G Darmstadt Dereje Duguma Addisalem Fikre Bizuayehu Gashaw Andualem Abebe Gebremariam Gobezayehu Tedros Hailu Abay H L Mohan Arun Jadaun K Jayanna F N U Kajal Arin Kar Raghav Krishna Aarti Kumar Vishwajeet Kumar Tarun Kumar Madhur Mulusew Lijalem Belew Rajini M Hajira Amin Prem K Mony Mekonnen Muleta Cynthia Pileggi-Castro Suman Pn Rao Abiy Seifu Estifanos Henok Tadele Abraham Tariku Ephrem Tekle Lemango Birkneh Tilahun Tadesse Ravi Upadhyay Bogale Worku Marta Yemane Hadush Grace J Chan Gary Lee Darmstadt HL Mohan Krishnamurthy Jayanna M Rajini Jose Carlos Martines Hajira Mohammed Amin Suman Rao Ravi Prakash Upadhyay |
| author_sort | Anteneh Asefa |
| collection | DOAJ |
| description | Introduction Kangaroo Mother Care (KMC) is the practice of early, continuous and prolonged skin-to-skin contact between the mother and the baby with exclusive breastfeeding. Despite clear evidence of impact in improving survival and health outcomes among low birth weight infants, KMC coverage has remained low and implementation has been limited. Consequently, only a small fraction of newborns that could benefit from KMC receive it.Methods and analysis This implementation research project aims to develop and evaluate district-level models for scaling up KMC in India and Ethiopia that can achieve high population coverage. The project includes formative research to identify barriers and contextual factors that affect implementation and utilisation of KMC and design scalable models to deliver KMC across the facility-community continuum. This will be followed by implementation and evaluation of these models in routine care settings, in an iterative fashion, with the aim of reaching a successful model for wider district, state and national-level scale-up. Implementation actions would happen at three levels: ‘pre-KMC facility’—to maximise the number of newborns getting to a facility that provides KMC; ‘KMC facility’—for initiation and maintenance of KMC; and ‘post-KMC facility’—for continuation of KMC at home. Stable infants with birth weight<2000 g and born in the catchment population of the study KMC facilities would form the eligible population. The primary outcome will be coverage of KMC in the preceding 24 hours and will be measured at discharge from the KMC facility and 7 days after hospital discharge.Ethics and dissemination Ethics approval was obtained in all the project sites, and centrally by the Research Ethics Review Committee at the WHO. Results of the project will be submitted to a peer-reviewed journal for publication, in addition to national and global level dissemination.Study status WHO approved protocol: V.4—12 May 2016—Protocol ID: ERC 2716. Study implementation beginning: April 2017. Study end: expected March 2019.Trial registration number Community Empowerment Laboratory, Uttar Pradesh, India (ISRCTN12286667); St John's National Academy of Health Sciences, Bangalore, India and Karnataka Health Promotion Trust, Bangalore, India (CTRI/2017/07/008988); Society for Applied Studies, Delhi (NCT03098069); Oromia, Ethiopia (NCT03419416); Amhara, SNNPR and Tigray, Ethiopia (NCT03506698). |
| format | Article |
| id | doaj-art-e6d9541c53174c5fa0d47f1a6af28826 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-e6d9541c53174c5fa0d47f1a6af288262025-08-20T01:54:12ZengBMJ Publishing GroupBMJ Open2044-60552019-11-0191110.1136/bmjopen-2018-025879Kangaroo Mother Care implementation research to develop models for accelerating scale-up in India and Ethiopia: study protocol for an adequacy evaluationAnteneh Asefa0Rajiv Bahl1Sarmila Mazumder2Nita Bhandari3Jose Martines4Lynn M Sibley5Nalini Singhal6Khalid Aziz7Thomas Brune8Araya Abrha Medhanyie9Hibret Alemu10Selemawit Asfaw Beyene11Fisseha Ashebir Gebregizabher12Habtamu Beyene13Grace Chan14John N Cranmer15G Darmstadt16Dereje Duguma17Addisalem Fikre18Bizuayehu Gashaw Andualem19Abebe Gebremariam Gobezayehu20Tedros Hailu Abay21H L Mohan22Arun Jadaun23K Jayanna24F N U Kajal25Arin Kar26Raghav Krishna27Aarti Kumar28Vishwajeet Kumar29Tarun Kumar Madhur30Mulusew Lijalem Belew31Rajini M32Hajira Amin33Prem K Mony34Mekonnen Muleta35Cynthia Pileggi-Castro36Suman Pn Rao37Abiy Seifu Estifanos38Henok Tadele39Abraham Tariku40Ephrem Tekle Lemango41Birkneh Tilahun Tadesse42Ravi Upadhyay43Bogale Worku44Marta Yemane Hadush45Grace J Chan46Gary Lee DarmstadtHL MohanKrishnamurthy Jayanna47M RajiniJose Carlos MartinesHajira Mohammed AminSuman RaoRavi Prakash Upadhyay48Department of Public Health, Institute of Tropical Medicine, Antwerp, BelgiumDepartment of Medicine, World Health Organization, Geneva, SwitzerlandCenter for Health Research and Development, Society for Applied Studies, New Delhi, IndiaCenter for Health Research and Development, Society for Applied Studies, New Delhi, IndiaDepartment of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, SwitzerlandEmory University, Atlanta, Georgia, USAPediatrics, University of Calgary, Calgary, Alberta, CanadaDepartment of Pediatrics, University of Alberta, Edmonton, Alberta, CanadaSachs’ Children and Youth Hospital, Stockholm, SwedenSchool of Public Health, College of Health Sciences, Mekelle University, Mekelle, EthiopiaUrban Health, John Snow Inc, Addis Ababa, EthiopiaSchool of Public Health, College of Health Sciences, Mekelle University, Mekelle, EthiopiaTigray Regional Health Bureau, Mekelle, EthiopiaRegional Health Bureau, Southern Nations Nationalities and Peoples` Region, Hawassa, EthiopiaBoston Children’s Hospital, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USAEmory University, Atlanta, Georgia, USADepartment of Pediatrics, Stanford University School of Medicine, Stanford, California, USAFederal Ministry of Health, Addis Ababa, EthiopiaSt. Paul’s Hospital Millennium Medical College, Addis Ababa, EthiopiaAmhara National Regional Health Bureau, Bahir Dar, EthiopiaEmory Ethiopia-Country Office, Addis Ababa, EthiopiaDepartment of Pediatrics and Child Health, Mekelle University College of Health Sciences, Mekelle, EthiopiaKarnataka Health Promotion Trust, Rajajinagar, IndiaCentre for Health Research and Development, Society for Applied Studies, New Delhi, IndiaQuality Improvement, Karnataka Health Promotion Trust, Bangalore, IndiaNational Health Mission, Indian Administrative Service, Lucknow, IndiaKarnataka Health Promotion Trust, Rajajinagar, IndiaCommunity Empowerment Lab, Lucknow, Uttar Pradesh, IndiaCommunity Empowerment Lab, Lucknow, Uttar Pradesh, IndiaCommunity Empowerment Lab, Lucknow, Uttar Pradesh, IndiaCentre for Health Research and Development, Society for Applied Studies, New Delhi, IndiaEmory Ethiopia-Amhara Regional Office, Bahir Dar, EthiopiaDepartment of Health and Family Welfare, Government of Karnataka, Bangalore, IndiaEmory Ethiopia, Addis Ababa, EthiopiaDivision of Epidemiology & Population Health, St John`s Medical College and Research Institute, Bangalore, IndiaPrivate Consultant, Addis Ababa, EthiopiaDepartment of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, SwitzerlandDepartment of Neonatology, St John`s Medical College Hospital, Bengaluru, Karnataka, IndiaSchool of Public Health, Addis Ababa University, Addis Ababa, EthiopiaCollege of Health Sciences, Department of Paediatrics and Child Health, Addis Ababa University, Addis Ababa, EthiopiaMaternal & Child Health Department, Federal Ministry of Health, Addis Ababa, EthiopiaMaternal and Child Health Directorate, Federal Ministry of Health, Addis Ababa, EthiopiaDepartment of Pediatrics and Child Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, EthiopiaCentre for Health Research and Development, Society for Applied Studies, New Delhi, IndiaAddis Ababa University, School of Public Health, Addis Ababa, EthiopiaDepartment of Pediatrics and Child Health, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, EthiopiaDepartment of Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USAKarnataka Health Promotion Trust, Bangalore, IndiascientistIntroduction Kangaroo Mother Care (KMC) is the practice of early, continuous and prolonged skin-to-skin contact between the mother and the baby with exclusive breastfeeding. Despite clear evidence of impact in improving survival and health outcomes among low birth weight infants, KMC coverage has remained low and implementation has been limited. Consequently, only a small fraction of newborns that could benefit from KMC receive it.Methods and analysis This implementation research project aims to develop and evaluate district-level models for scaling up KMC in India and Ethiopia that can achieve high population coverage. The project includes formative research to identify barriers and contextual factors that affect implementation and utilisation of KMC and design scalable models to deliver KMC across the facility-community continuum. This will be followed by implementation and evaluation of these models in routine care settings, in an iterative fashion, with the aim of reaching a successful model for wider district, state and national-level scale-up. Implementation actions would happen at three levels: ‘pre-KMC facility’—to maximise the number of newborns getting to a facility that provides KMC; ‘KMC facility’—for initiation and maintenance of KMC; and ‘post-KMC facility’—for continuation of KMC at home. Stable infants with birth weight<2000 g and born in the catchment population of the study KMC facilities would form the eligible population. The primary outcome will be coverage of KMC in the preceding 24 hours and will be measured at discharge from the KMC facility and 7 days after hospital discharge.Ethics and dissemination Ethics approval was obtained in all the project sites, and centrally by the Research Ethics Review Committee at the WHO. Results of the project will be submitted to a peer-reviewed journal for publication, in addition to national and global level dissemination.Study status WHO approved protocol: V.4—12 May 2016—Protocol ID: ERC 2716. Study implementation beginning: April 2017. Study end: expected March 2019.Trial registration number Community Empowerment Laboratory, Uttar Pradesh, India (ISRCTN12286667); St John's National Academy of Health Sciences, Bangalore, India and Karnataka Health Promotion Trust, Bangalore, India (CTRI/2017/07/008988); Society for Applied Studies, Delhi (NCT03098069); Oromia, Ethiopia (NCT03419416); Amhara, SNNPR and Tigray, Ethiopia (NCT03506698).https://bmjopen.bmj.com/content/9/11/e025879.full |
| spellingShingle | Anteneh Asefa Rajiv Bahl Sarmila Mazumder Nita Bhandari Jose Martines Lynn M Sibley Nalini Singhal Khalid Aziz Thomas Brune Araya Abrha Medhanyie Hibret Alemu Selemawit Asfaw Beyene Fisseha Ashebir Gebregizabher Habtamu Beyene Grace Chan John N Cranmer G Darmstadt Dereje Duguma Addisalem Fikre Bizuayehu Gashaw Andualem Abebe Gebremariam Gobezayehu Tedros Hailu Abay H L Mohan Arun Jadaun K Jayanna F N U Kajal Arin Kar Raghav Krishna Aarti Kumar Vishwajeet Kumar Tarun Kumar Madhur Mulusew Lijalem Belew Rajini M Hajira Amin Prem K Mony Mekonnen Muleta Cynthia Pileggi-Castro Suman Pn Rao Abiy Seifu Estifanos Henok Tadele Abraham Tariku Ephrem Tekle Lemango Birkneh Tilahun Tadesse Ravi Upadhyay Bogale Worku Marta Yemane Hadush Grace J Chan Gary Lee Darmstadt HL Mohan Krishnamurthy Jayanna M Rajini Jose Carlos Martines Hajira Mohammed Amin Suman Rao Ravi Prakash Upadhyay Kangaroo Mother Care implementation research to develop models for accelerating scale-up in India and Ethiopia: study protocol for an adequacy evaluation BMJ Open |
| title | Kangaroo Mother Care implementation research to develop models for accelerating scale-up in India and Ethiopia: study protocol for an adequacy evaluation |
| title_full | Kangaroo Mother Care implementation research to develop models for accelerating scale-up in India and Ethiopia: study protocol for an adequacy evaluation |
| title_fullStr | Kangaroo Mother Care implementation research to develop models for accelerating scale-up in India and Ethiopia: study protocol for an adequacy evaluation |
| title_full_unstemmed | Kangaroo Mother Care implementation research to develop models for accelerating scale-up in India and Ethiopia: study protocol for an adequacy evaluation |
| title_short | Kangaroo Mother Care implementation research to develop models for accelerating scale-up in India and Ethiopia: study protocol for an adequacy evaluation |
| title_sort | kangaroo mother care implementation research to develop models for accelerating scale up in india and ethiopia study protocol for an adequacy evaluation |
| url | https://bmjopen.bmj.com/content/9/11/e025879.full |
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