KANGAROO MOTHER CARE IN LOW-RESOURCE SETTING: A STUDY OF HEALTHCARE PROFESSIONALS’ KNOWLEDGE, ATTITUDES, PRACTICES AND IMPLEMENTATION BARRIERS IN PAKISTAN

Abstract

Background: Kangaroo Mother Care (KMC) is a well-established, evidence-based intervention that improves survival, physiological stability, and maternal–infant bonding among preterm and low-birth-weight neonates. It is particularly valuable in low-resource healthcare settings, where access to advanced neonatal technology is limited. Despite global recommendations and proven effectiveness, the implementation of KMC remains inconsistent, largely due to gaps in healthcare workers’ knowledge, practice patterns, and systemic support. Understanding these gaps is essential to strengthen neonatal care services and promote sustainable KMC integration.

Objective: To assess the knowledge, attitudes, practices, and perceived barriers related to Kangaroo Mother Care among healthcare workers working in neonatal and maternal care units of a tertiary care hospital in Rawalpindi, Pakistan.

Methods: An analytical cross-sectional study was conducted among 40 healthcare workers, including staff nurses, house officers, and postgraduate residents, working in the Neonatal Intensive Care Unit, Gynecology, and Labor departments. Participants were recruited using convenience sampling. Data were collected using a structured, self-administered questionnaire adapted from standardized KAP frameworks. The tool assessed demographic characteristics, knowledge, attitudes, practices, and barriers related to KMC. Internal consistency of the questionnaire was confirmed with a Cronbach’s alpha of 0.80. Data were analyzed using SPSS software, employing descriptive statistics and chi-square tests.

Results: Among the participants, 85% (n = 34) were female and 67.5% (n = 27) were staff nurses. Moderate knowledge of KMC was observed in 90% (n = 36) of respondents, while 10% (n = 4) demonstrated low knowledge. A positive attitude toward KMC was reported by 67.5% (n = 27), whereas 30% (n = 12) showed neutral attitudes and 2.5% (n = 1) negative attitudes. In practice, 75% (n = 30) reported inconsistent KMC application, 15% (n = 6) practiced KMC regularly, and 10% (n = 4) reported minimal practice. High perceived barriers were identified by 60% (n = 24), primarily related to workload, resource limitations, and administrative constraints.

Conclusion: Although healthcare workers demonstrated moderate knowledge and largely positive attitudes toward KMC, its consistent implementation remained limited due to systemic and organizational barriers. Strengthening training programs, improving infrastructure, and enhancing institutional and policy-level support are essential to translate knowledge into sustained clinical practice.