Progress with the Implementation of Kangaroo Mother Care in Four Regions in Ghana

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Aim:
To measure progress with the implementation of Kangaroo Mother Care (KMC) for low birth-weight (LBW) infants at a health systems level.

Design:
Action research design, with district and re- gional hospitals as the unit of analysis.

Setting:
Four regions in Ghana, identified by the Ghana Health Service and UNICEF.

Participants:
Health workers and officials, health care facilities and districts in the four regions.

Intervention:
A one-year implementation programme with three phases: (1) introduction to KMC, skills de- velopment in KMC practice and the management of implementation; (2) advanced skills development for regional steering committee members; and (3) an as- sessment of progress at the end of the intervention.

Main outcome measures:
Description of practices, services and facilities for KMC and the identification of strengths and challenges.

Results:
Twenty-six of 38 hospitals (68%) demonstrated sufficient progress with KMC implementation. Half of the hospitals had designated a special ward for KMC. 66% of hospitals used a special record for in- fants receiving KMC. Two of the main challenges were lack of support for mothers who had to remain with their LBW infants in hospital and no follow-up review services for LBW infants in 39% of hospitals.

Conclusions:
It was possible to roll out KMC in Ghana, but further support for the regions is needed to maintain the momentum. Lessons learned from this project could inform further scale-up of KMC and oth- er projects in Ghana.