Barriers to Implementation of Facility-based Kangaroo Mother Care for Pre-term and Low Birth Weight Infants in River Nile State, Sudan; 2014

Background: Prematurity and low birth weight (LBW) currently account for approximately 40% of
neonatal deaths in developing countries.
Objectives: To identify major factors that limit the introduction of kangaroo mother care (KMC)
services in River Nile State, Sudan.
Methods: A facility based qualitative cross-sectional study conducted in two hospitals (Atbara and Al-
Damar hospital). A total of seven pediatricians working in these two hospitals were interviewed using
semi – structured interview.
Analysis: Analysis of the data was done manually. The interviewers' responses were entered into a
data collection template. The data were reviewed and common themes were identified.
Results: Prematurity and low birth weight were a major health problem. Respiratory distress
syndrome, hypothermia and sepsis were the leading causes of death. Problems facing pediatricians
when caring for the preterm were; lack of incubators, non-functioning incubators, insufficient and
untrained staff especially nurses beside rapid turnover. Only two of our pediatricians had heard about
KMC but all of them were willing to adopt it in their units. Lack of awareness among mothers, health
staff and the community, and the community health culture were the main two obstacles to KMC
implementation. Financial support, staff training and isolated wards were needed for mothers' privacy.
Knowledgeable practitioners to develop evidence-based policies were important for KMC
implementation. Raising awareness among mothers, health cadre especially nurses caring for
mothers and their babies and the community about KMC.
Conclusion: Lack of knowledge among health cadre, mother, families and community were obstacles
to KMC. Awareness need to be raised.