COMPARISON OF KANGAROO MOTHER CARE (KMC) IN HOSPITAL AND POSTDISCHARGE: ENABLERS AND INHIBITORS.

Abstract

Background: Kangaroo Mother Care (KMC), involving skin-to-skin contact and exclusive breastfeeding, is a cost-effective and evidence-based strategy to improve survival and health outcomes among low-birth-weight (LBW) and preterm neonates. While hospitals provide a structured environment to initiate KMC, continuity at home plays a vital role in long-term adherence. However, enablers and inhibitors influencing KMC vary significantly across care settings. Identifying these factors is essential to optimize its practice both in clinical and community environments.

Objective: To compare the enablers and inhibitors of Kangaroo Mother Care (KMC) implementation in hospital and post-discharge home settings to improve neonatal care outcomes.

Methods: This prospective observational study was conducted in the Department of Neonatal Medicine at Services Hospital, Lahore, from January 2024 to August 2024. A total of 200 mothers of LBW neonates (<2.5 kg) practicing KMC were enrolled—100 during hospital stay and 100 at home post-discharge. Data were collected using a structured questionnaire assessing enablers and inhibitors, along with demographic and clinical details. Analysis was performed using SPSS version 27, applying descriptive and inferential statistics including independent t-tests.

Results: The mean maternal age was 28.4 ± 4.6 years; 162 (81%) neonates were preterm and 38 (19%) were full-term. The mean gestational age was 34.8 ± 1.99 weeks, and the average birth weight was 1.76 ± 0.34 kg. The mean enabler score was significantly higher at home (77.75 ± 4.33) compared to hospital settings (69.1 ± 10.3, P = 0.047). Conversely, the mean inhibitor score was significantly higher in hospitals (30.8 ± 10.3) than at home (22.2 ± 4.33, P = 0.045).

Conclusion: Home settings offer a more supportive environment for KMC, with significantly greater enablers and fewer inhibitors compared to hospital settings. Strengthening post-discharge support and minimizing hospital-related barriers are critical for sustaining KMC practices.