The presence of physician champions improved Kangaroo mother care in rural western India
School of Medicine; Graduate School of Biomedical Sciences, Clinical and Population Health Research Program; MD/PhD Program; Department of Quantitative Health Sciences
Health Services Research | International Public Health | Maternal and Child Health | Pediatrics | Translational Medical Research
AIM: This study determined the effect of physician champions on the two main components of Kangaroo mother care (KMC): skin-to-skin care and breastfeeding.
METHODS: KMC practices among a retrospective cohort of 648 infants admitted to a rural Indian neonatal intensive care unit (NICU) between 5 January 2011 and 7 October 2014 were studied. KMC champions were identified based on their performance evaluation. We examined the effect of withdrawing physician champions on overall use, time to initiation and intensity of skin-to-skin care and breastfeeding, using separate models.
RESULTS: In comparison to when KMC champions were present, their absence was associated with a 45% decrease in the odds of receiving skin-to-skin care, with a 95% Confidence Interval (CI) of 64% to 17%, a 38% decrease in the rate of initiation skin-to-skin care (95% CI 53% to 82%) and an average of 1.47 less hours of skin-to-skin care (95% CI -2.07 to -0.86). Breastfeeding practices were similar across the different champion environments.
CONCLUSION: Withdrawing physician champions from the NICU setting was associated with a decline in skin-to-skin care, but not breastfeeding. Training healthcare workers and community stakeholders to become champions could help to scale up and maintain KMC practices.
DOI of Published Version
Acta Paediatr. 2016 Apr 25. doi: 10.1111/apa.13445. Link to article on publisher's site
Acta paediatrica (Oslo, Norway : 1992)
Soni, Apurv; Amin, Amee; Patel, Dipen V.; Fahey, Nisha; Shah, Nikhil; Phatak, Ajay G.; Allison, Jeroan J.; and Nimbalkar, Somashekhar M., "The presence of physician champions improved Kangaroo mother care in rural western India" (2016). UMass Center for Clinical and Translational Science Supported Publications. 69.