Why is Kangaroo Mother Care not yet scaled in the UK? A systematic review and realist synthesis of a frugal innovation for newborn care. Issue 1 (22nd October 2021)

• Record Type: Journal Article
• Authors: Stefani, Giulietta; Skopec, Mark; Battersby, Cheryl; Harris, Matthew
• Is Part Of: BMJ innovations. Volume 8:Issue 1(2022)
• Page Start: 9
• Page End: 20
• Publication Date: 2021-10-22
• Subjects: child health -- delivery of health care -- global health -- health services research; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjinnov-2021-000828
• Languages: English
• ISSNs: 2055-8074

Abstract

Abstract : Objective: Kangaroo Mother Care (KMC) is a frugal innovation improving newborn health at a reduced cost compared with incubator use. KMC is widely recommended; however, in the UK, poor evidence exists on KMC, and its implementation remains inconsistent. Design: This Systematic Review and Realist Synthesis explores the barriers and facilitators in the implementation of KMC in the UK. Data source: OVID databases, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus and Google Scholar were searched. Eligibility criteria: Studies were UK based, in maternity/neonatal units, for full-term/preterm children. First screening included studies on (1) KMC, Kangaroo Care (KC) or skin-to-skin contact (SSC) or (2) Baby Friendly Initiative, Small Wonders Change Program or family-centred care if in relation to KMC/KC/SSC. Full texts were reviewed for evidence regarding KMC/KC/SSC implementation. Results: The paucity of KMC research in the UK did not permit a realist review. However, expanded review of available published studies on KC and SSC, used as a proxy to understand KMC implementation, demonstrated that the main barriers are the lack of training, knowledge, confidence and clear guidelines. Conclusion: The lack of KMC implementation research in the UK stands in contrast to the already well-proven benefits of KMC for stable babies in low-income contexts and highlights the need for further research, especially in sick and small newborn population. Implementation of, and research into, KC/SSC is inconsistent and of low quality. Improvements are needed to enhance staff training and parental support, and to develop guidelines to properly implement KC/SSC. It should be used as an opportunity to emphasise the focus on KMC as a potential cost-effective alternative to reduce the need for incubator use in the UK.