Mothers’ Perspectives and Experiences of Kangaroo Mother Care in the Fezile Dabi Health District, South Africa: A Qualitative Study

Abstract

Kangaroo mother care (KMC) is a high-impact, cost-effective intervention to improve the health outcomes of preterm and low birth weight infants. This evidence-based method is safe, increases infant survival and has positive physiological, behavioural, neuroprotective, and psychosocial effects. The qualitative study reported here explored on mothers’ perspectives and experiences of KMC in the Fezile Dabi District in South Africa. In-depth interviews were conducted with five healthcare workers from the neonatal unit and 13 mothers practising KMC at the Boitumelo Regional Hospital or who had been in the KMC ward before discharge. A deductive analysis identified barriers and enablers to KMC practice, followed by an inductive analysis of participants’ perspectives and experiences of KMC. Most mothers had positive views of KMC, but reported minimal preparation during pregnancy for preterm birth or KMC. This led to initial mixed emotional reactions, including being shocked, worried, and happy that the baby was alive. Over time, mothers accepted the value of skin-to-skin care and exclusive breastfeeding. On discharge, they were counselled and all looked forward to taking their babies home. Healthcare workers highlighted their roles in supporting KMC and emphasised the importance of paternal involvement in caring for both the mother and the premature infant. The findings from the barriers-enablers analysis yielded two themes: support for mothers and the health system. Support for mothers encompassed psychosocial and financial support, which e KMC. In the hospital, healthcare workers played a crucial role by providing emotional support, sharing KMC knowledge, and offering practical guidance on positioning the baby, thermal care, feeding, and hygiene. This support helped ease mothers’ fears and boosted their confidence in continuing KMC at home. Most mothers received some family support eat home, although paternal involvement was limited if the father lived separately. Financially, the majority of mothers were unemployed and relied on family support and government grants. The findings related to the health system theme are organised according to its key building blocks. Several barriers to optimal KMC services were identified, including a lack of leadership and management support to address the implementation of KMC policies, limited budgets for infrastructure improvements, a shortage of skilled healthcare workers, and inadequate supplies.