We are facing some barriers: A qualitative study on the implementation of kangaroo mother care from the perspectives of healthcare providers


  • Qory Tifani Rahmatika Faculty of Sports Science, Universitas Negeri Malang
  • Ronal Surya Aditya Faculty of Sports Science, Universitas Negeri Malang
  • Ah. Yusuf Faculty of Nursing, Universitas Airlangga, Surabaya
  • Reem lafi Almutairi Department of Public Health, College of Public Health and Informatics, University of Hail
  • Daifallah M. Al Razeeni Department of EMS, King Saud University, Riyadh
  • Siti Kotijah Bina Sehat PPNI, Mojokerto
  • Anita Sulistyorini Faculty of Sports Science, Universitas Negeri Malang




Kangaroo Mother Care, healthcare professionals, implementation, challenges, facilitators


Health systems at all levels are under pressure to provide comprehensive and high quality of care based on the best evidencebased interventions. The kangaroo mother care (KMC) is one way to care for Low Birth Weight babies (LBW) especially in developing country where the rates of preterm and LBW neonates are higher and the resources are limited. The purpose of this paper is to explore healthcare providers’ perspectives of kangaroo mother care implementation in perinatology ward in the rural surgical hospital of East Java Province, Indonesia. We conducted an in-depth interviews to identify KMC implementations. Ten healthcare providers engaged with KMC were interviewed. Data was analyzed using a thematic analysis. Healthcare providers reported positives perceptions of KMC and acknowledged their important roles to give education. The barriers in implementing the KMC including the level of knowledge and the age of the mother of LBW babies. KMC as a method of treating LBW babies is effective intervention care of preterm and LBW babies. This research provides information regarding the need of supports from all levels in KMC implementation.

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UNICEF. Under Five Mortality. 2021.

WHO. Global Health Observatory Data Repository. 2019.

Zoleko-Manego R, Mischlinger J, Dejon-Agobe JC, Basra A, MacKanga JR, Diop DA, et al. Birth weight, growth, nutritional status and mortality of infants from Lambarene and Fougamou in Gabon in their first year of life. PLoS One. 2021;16(2 February):1–15. DOI: https://doi.org/10.1371/journal.pone.0246694

Lawn JE, Cousens SN, Darmstadt GL, Bhutta ZA, Martines J, Paul V, et al. 1 year after The Lancet Neonatal Survival Series-was the call for action heard? Lancet. 2006;367(9521):1541–7. DOI: https://doi.org/10.1016/S0140-6736(06)68587-5

Chan GJ, Labar AS, Wall S, Atun R. Kangaroo mother care: A systematic review of barriers and enablers. Bull World Health Organ. 2016;94(2):130J-141J. DOI: https://doi.org/10.2471/BLT.15.157818

Agbozo F, Abubakari A, Der J, Jahn A. Prevalence of low birth weight, macrosomia and stillbirth and their relationship to associated maternal risk factors in Hohoe Municipality, Ghana. Midwifery. 2016;40:200–6. DOI: https://doi.org/10.1016/j.midw.2016.06.016

Ariff S, Maznani I, Bhura M, Memon Z, Arshad T, Samejo TA, et al. Understanding Perceptions and Practices for Designing an Appropriate Community-Based Kangaroo Mother Care Implementation Package: Qualitative Exploratory Study. JMIR Form Res. 2022;6(1):1–13. DOI: https://doi.org/10.2196/30663

WHO. Maternal Mortality. 2019.

Bergman NJ, Linley LL, Fawcus SR. Randomized controlled trial of skin-to-skin contact from birth versus conventional incubator for physiological stabilization in 1200- to 2199-gram newborns. Acta Paediatr Int J Paediatr. 2004;93(6):779–85. DOI: https://doi.org/10.1111/j.1651-2227.2004.tb03018.x

Karimi FZ, Sadeghi R, Maleki-Saghooni N, Khadivzadeh T. The effect of mother-infant skin to skin contact on success and duration of first breastfeeding: A systematic review and meta-analysis. Taiwan J Obstet Gynecol. 2019;58(1):1–9. DOI: https://doi.org/10.1016/j.tjog.2018.11.002

Mekonnen AG, Yehualashet SS, Bayleyegn AD. The effects of kangaroo mother care on the time to breastfeeding initiation among preterm and LBW infants: A meta-analysis of published studies. Int Breastfeed J. 2019;14(1):12–7. DOI: https://doi.org/10.1186/s13006-019-0206-0

Lewis TP, Andrews KG, Shenberger E, Betancourt TS, Fink G, Pereira S, et al. Caregiving can be costly: A qualitative study of barriers and facilitators to conducting kangaroo mother care in a US tertiary hospital neonatal intensive care unit. BMC Pregnancy Childbirth. 2019;19(1):1–12. DOI: https://doi.org/10.1186/s12884-019-2363-y

Tallandini MA, Scalembra C. Kangaroo Mother Care and mother-premature infant dyadic interaction. Infant Ment Health J. 2006;27(3):251–75. DOI: https://doi.org/10.1002/imhj.20091

Zych B, Błaż W, Dmoch-Gajzlerska E, Kanadys K, Lewandowska A, Nagórska M. Perception of stress and styles of coping with it in parents giving kangaroo mother care to their children during hospitalization in nicu. Int J Environ Res Public Health. 2021;18(23). DOI: https://doi.org/10.3390/ijerph182312694

Kourouma KR, Agbré-Yacé ML, Doukouré D, Cissé L, Some-Méazieu C, Ouattara J, et al. Barriers and facilitators to kangaroo mother care implementation in Cote d’Ivoire: a qualitative study. BMC Health Serv Res. 2021;21(1):1–15. DOI: https://doi.org/10.1186/s12913-021-07086-9

Kristiawati, Rustina Y, Budi I, Hariyati RTS. How to prepare your preterm baby before discharge. Sri Lanka J Child Heal. 2020;49(4):390–5. DOI: https://doi.org/10.4038/sljch.v49i4.9274

Mustikawati IS, Pratomo H, Martha E, Murty AI. Knowledge, Attitude, and Practice using the Kangaroo Method Care in Maternal with Low Birth Weight Babies. J Kesehat Masy. 2022;17(3):436–43. DOI: https://doi.org/10.15294/kemas.v17i3.29548

Aliganyira P, Kerber K, Davy K, Gamache N, Sengendo NH, Bergh AM. Helping small babies survive: An evaluation of facility-based Kangaroo Mother Care implementation progress in Uganda. Pan Afr Med J. 2014;19:1–10. DOI: https://doi.org/10.11604/pamj.2014.19.37.3928

Bergh AM, De Graft-Johnson J, Khadka N, Om’Iniabohs A, Udani R, Pratomo H, et al. The three waves in implementation of facility-based kangaroo mother care: A multi-country case study from Asia. BMC Int Health Hum Rights. 2016;16(1). DOI: https://doi.org/10.1186/s12914-016-0080-4

Feucht U, van Rooyen E, Skhosana R, Bergh AM. Taking kangaroo mother care forward in South Africa: The role of district clinical specialist teams. South African Med J. 2016;106(1):49–52. DOI: https://doi.org/10.7196/SAMJ.2016.v106i1.10149

Pratomo H, Uhudiyah U, Sidi IPS, Rustina Y, Suradi R, Bergh AM, et al. Supporting factors and barriers in implementing kangaroo mother care in Indonesia. Paediatr Indones. 2012;52(1):43–50. DOI: https://doi.org/10.14238/pi52.1.2012.09

Utami S, Huang MC. Health care providers’ perception, knowledge, barriers and practice of kangaroo care for preterm baby in Indonesia. J Neonatal Nurs. 2019;25(4):205–8. DOI: https://doi.org/10.1016/j.jnn.2019.03.003

Mohammadi M, Sattarzadeh N, Heidarzadeh M, Hosseini MB, Hakimi S. Implementation Barriers for Practicing Continuous Kangaroo Mother Care from the Perspective of Neonatologists and Nurses. J Caring Sci. 2021;10(3):137–44. DOI: https://doi.org/10.34172/JCS.2021.005

Jamali QZ, Shah R, Shahid F, Fatima A, Khalsa S, Spacek J, et al. Barriers and enablers for practicing kangaroo mother care (KMC) in rural Sindh, Pakistan. PLoS One. 2019;14(6):1–15. DOI: https://doi.org/10.1371/journal.pone.0213225

Smith ER, Bergelson I, Constantian S, Valsangkar B, Chan GJ. Barriers and enablers of health system adoption of kangaroo mother care: A systematic review of caregiver perspectives. BMC Pediatr. 2017;17(1):1–16. DOI: https://doi.org/10.1186/s12887-016-0769-5

ten Ham W, Minnie KCS, van der Walt CSJC. Health care professionals’ perspectives on the requirements facilitating the roll-out of kangaroo mother care in South Africa. Heal SA Gesondheid. 2016;21(0):228–37. DOI: https://doi.org/10.1016/j.hsag.2015.10.005

Bilal SM, Tadele H, Abebo TA, Tadesse BT, Muleta M, W/Gebriel F, et al. Barriers for kangaroo mother care (KMC) acceptance, and practices in southern Ethiopia: a model for scaling up uptake and adherence using qualitative study. BMC Pregnancy Childbirth. 2021;21(1):1–12. DOI: https://doi.org/10.1186/s12884-020-03409-6

Kinshella MLW, Salimu S, Pickerill K, Vidler M, Banda M, Newberry L, et al. “Like works of our hands are giving testimony!” A qualitative study on kangaroo mother care and health worker empowerment in southern Malawi. Afr J Reprod Health. 2021;25(3 Special Issue):65–73.

Seidman G, Unnikrishnan S, Kenny E, Myslinski S, Cairns-Smith S, Mulligan B, et al. Barriers and enablers of Kangaroo mother care practice: A systematic review. PLoS One. 2015;10(5):1–20. DOI: https://doi.org/10.1371/journal.pone.0125643

Kampekete GSM, Ngoma C, Masumo M. Acceptance of kangaroo mother care by mothers of premature babies. Afr J Midwifery Womens Health. 2018;12(4):178–88. DOI: https://doi.org/10.12968/ajmw.2018.12.4.178




How to Cite

Rahmatika, Q. T., Aditya, R. S., Yusuf, A., Almutairi, R. lafi, Al Razeeni, D. M., Kotijah, S., & Sulistyorini, A. (2022). We are facing some barriers: A qualitative study on the implementation of kangaroo mother care from the perspectives of healthcare providers. Journal of Public Health in Africa, 13(s2). https://doi.org/10.4081/jphia.2022.2412