Improving Skin-to-Skin Practice for babies in Kangaroo Mother Care in Malawi through the use of a customized baby wrap: A randomized control trial
Improving Skin-to-Skin Practice for babies in Kangaroo Mother Care in Malawi through the use of a customized baby wrap: A randomized control trial
复制标题
DOI：
10.1371/journal.pone.0229720
复制
发表时间：
2020-03-19
期刊：
影响因子：
3.7
通讯作者：
Dube, Queen
中科院分区：
文献类型：
--
作者：
Chavula, Kondwani;Guenther, Tanya;Dube, Queen
背景早产并发症是马拉维新生儿死亡的主要原因。尽管袋鼠妈妈护理 (KMC) 很早就被采用，但覆盖率仍然很低，而且妇女在使用传统包装纸 chitenje 方面表示面临挑战。 2016 年，开展了一项研究，旨在评估定制 KMC 包裹在提高母亲对 KMC 实践依从性方面的可接受性和有效性。方法母婴二人组 (301) 被随机分配接受挪度全球健康公司开发的定制 CarePlus 包裹或传统 chitenje。入院后 2-3 天，在 KMC 病房对登记的母婴进行评估，然后在出院后 7-15 天再次进行评估。涵盖的主题包括肌肤接触的做法、母乳喂养、对包裹的看法以及家庭/社区支持。卡方检验用于评估包裹类型和 KMC 实践之间的关联。该研究获得了伦理批准。结果这项研究发现，定制的 KMC 裹敷对于女性来说是高度可接受的，并且改善了基于设施的 KMC 中的肌肤接触实践：44% 使用定制裹敷的母亲报告每天工作 20 小时或以上，而使用传统 chitenje 的母亲只有 33% 的人每天工作 20 小时或以上。据报告，使用定制裹布的女性比使用 chitenje 的女性更能舒服地让婴儿保持皮肤接触的姿势（96% 比 71%），而且她们能够自己系上裹布（86% 比 10%）。从 KMC 出院时，使用定制裹敷的女性比使用传统 chitenje 的女性对裹敷感到满意的比例更高（94% vs. 56%）。定制的包裹似乎不会影响其他新生儿的做法，例如母乳喂养。结论这项研究提供的证据表明，定制的 KMC 包裹非常受母亲欢迎，并且有助于更好的肌肤接触做法。除了其他干预措施之外，使用定制的包裹可能是支持母亲练习 KMC 和皮肤接触的一种机制。
BackgroundComplications of prematurity are a leading cause of newborn death in Malawi. Despite early adoption of Kangaroo mother care (KMC), coverage remains low and women have expressed challenges in using the traditional wrapper-chitenje. In 2016, a study was conducted to evaluate the acceptability and effectiveness of a customized KMC wrap in improving adherence to KMC practices among mothers.MethodsMother-baby dyads (301) were randomized to receive either a customized CarePlus Wrap developed by Laerdal Global Health or a traditional chitenje. Enrolled mother-baby dyads were assessed in the KMC ward at 2-3 days after of admission, and then again at 7-15 days post-discharge. Topics covered included skin-to-skin practices, breastfeeding, perceptions of the wrap, and family/community support. Chi square tests were used to assess associations between wrap type and KMC practices. The study received ethics approval.ResultsThis study found that a customized KMC wrap is highly acceptable to women and improved skin-to-skin practices in facility-based KMC: 44% of mothers using a customized wrap reported 20 or more hours per day, compared to 33% of mothers using the traditional chitenje. Women using the customized wrap reported being comfortable in keeping the baby in skin-to-skin position more often than women using the chitenje (96% vs. 71%), and they were able to tie on the wrap themselves (86% vs. 10%). At the time of discharge from KMC, more women who used the customized wrap were satisfied with the wrap than those who used the traditional chitenje (94% vs. 56%). The customized wrap did not appear to impact other newborn practices, such as breastfeeding.ConclusionsThis study provides evidence that a customized KMC wrap is highly acceptable to mothers, and it can contribute to better skin-to-skin practices. Use of a customized wrap may be one mechanism to support mothers in practicing KMC and skin-to-skin contact in addition to other interventions.