Health professional assisted Kangaroo mother care practice in Ethiopian health care facilities: Evidence from the 2016 Ethiopian demographic and health survey

doi:10.21203/rs.3.rs-2214783/v1

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Health professional assisted Kangaroo mother care practice in Ethiopian health care facilities: Evidence from the 2016 Ethiopian demographic and health survey

https://doi.org/10.21203/rs.3.rs-2214783/v1

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published 24 Aug, 2023

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Background: Worldwide, 15million children born prematurely every year and over one million of them died because of premature birth complications. However, three-fourths of deaths from preterm birth complications are preventable without intensive care units. One of the prevention methods is Kangaroo Mother Care (KMC). KMC is a method of holding neonate in skin-to skin contact immediately following birth or latter in upright prone position on the maternal chest. An evidence stated that KMC can prevent up to half of all deaths in neonates weighing <2000gm at birth. The Ethiopian government also developed and has been implementing a guideline on putting all low birth weight (LBW) neonates at KMC. The aim of this study was to assess health professionals’ assisted Kangaroo mother care practice and its associated factors among mothers who gave birth at health facility in Ethiopia.

Methodology: This study used the 2016Ethiopian Demographic and Health Survey data (EDHS). The 2016EDHS used a stratified two stage sampling method to select a representative sample for the country. According to the 2016 EDHS data, all the regions were stratified into urban and rural areas. Before analyzing the data, weighting, cluster and strata adjustment were performed to get representative sample and appropriate to population size estimates. The study sample used in this study after cleaning the children’s dataset from the 2016EDHS is 2,760. A logistic regression model was used to assess the association between health professional assisted KMC practice and predefined independent variables.

Results: Mothers who gave birth in a health facility and practiced kangaroo mother care were 1808 (62.1%), 95% CI (60.3, 63.9).The remained mothers did not practice KMC, although they gave birth in health facilities under the support of trained health professionals.

In the multivariable logistic regression analysis; only wealth index, poorest (AOR, (95%CI)), (0.60, (0.43, 0.81)), and poorer (0.62, (0.46, 0.86)) socio-economic status were decreasing the practice of health professionals assisted KMC practice.

Conclusions: The coverage of health professional assisted KMC practice was low, which was far lower than the expectation for mothers who gave birth in health facilities. Low socio-economic status (low wealth index) was associated with lack of practicing KMC. The minister of health and research institutes may study further why mothers from low income did not practicing KMC while they are in health facilities’ KMC center.

Children

Factors

KMC

Health Professional

Health Facilities

2016EDHS

Worldwide, 15 million children born prematurely every year and over one million died because of premature birth complications (1). Pre-term birth (birth before 37completed weeks of gestation) is the direct and leading cause to three million neonatal deaths each year and the second leading cause of all deaths in under-five children globally (2, 3). However, three-fourths of deaths from preterm birth complications are preventable without intensive care units(4). Neonatal period by itself presents the greatest risk of death, which is exacerbated for preterm newborns as they have less physiological reserve, have greater challenges in temperature regulation, have immature organs, have poor immune function, and heightened vulnerability to severe infections putting them at risk for problems associated with the transition to extra uterine life(5, 6). Because of these and many other reasons, neonatal health begun to emerge as a global and national public health priority especially through attention to child survival in the Millennium Development Goals(7), which contribute more to emphasize on Kangaroo Mother Care (KMC). Kangaroo Mother Care is a method of holding a small neonate (< 2000gm) in skin-to skin contact (STS) at prone and upright position on the maternal chest in which the neonate is enclosed in maternal clothing for thermal regulation(8). KMC is an evidence-based inpatient care technique for premature and low-birth weight (LBW) neonate when he/she weigh less than 2000gm (9, 10). It is an easily available and biologically sound method of care for all newborns, but in particular for premature newborns(11). The clinical efficacy and health benefits of KMC to preterm and low-birth weight neonates (< 2000gm) has been widely demonstrated. According to a study, KMC can prevent up to half of all deaths in neonates weighing < 2000gm at birth (10).

According to Ethiopian and World Health Organization (WHO) guidelines, all LBW babies need to receive KMC. But, sick and very small neonates should initially be cared in a radiant warmer and KMC would be initiated once the baby is thermodynamically stable (12)). However, KMC may be still used in economically challenged countries like Ethiopia where access to incubators is limited or too expensive for the general population (13). In Ethiopia, KMC is a strategy to decrease neonatal mortality as it was stated clearly in the health sector transformation plan (HSTP), but only 46.4% of eligible neonates were received KMC (14). The coverage of KMC in Ethiopia has remained low and its implementation has largely been limited to specialized hospitals (15, 16). However, KMC shorten hospital stay and create opportunities for teaching mothers and assessing the progress of the neonate, and open a means for better use of health care (10, 17–19). But, a study indicated the existence of difference in between health facilities on practicing KMC in Ethiopia (20). Unlike Ethiopia, KMC has been widely implemented in western and some African countries including Nigeria, Madagascar, Malawi, Ghana, Indonesia (21, 22) and South Africa (23). Thus, the aim of this study was to assess health professional assisted Kangaroo mother care practice and its associated factors in mothers who gave birth in health facilities in Ethiopia.

Data collection period, and study population

The data collection period for the 2016EDHS was from January 18 to June 27, 2016. The 2016 Ethiopian Demographic and Health Survey (EDHS) data was used for this study. The 2016 EDHS data was the fourth survey conducted in Ethiopia. The survey collected information on household’s and respondent's characteristics, child health, infant and child mortality, malaria, maternal health, maternal mortality, nutrition, tobacco use, women's empowerment, anemia, domestic violence, environmental health, family planning, fertility and fertility preferences, and etc. The purpose of the EDHS is to provide up-to-date estimates of the key demographic and health indicators of the population (24). The survey included reproductive age group women, under-five children, and productive age group men (15-59years old) (24, 25).

Sampling Techniques, Procedures And Study Design

The 2016EDHS data was collected using a stratified two stage sampling method to select a representative sample. All the regions of the country were stratified into urban and rural areas. From all the 11administrative states, 21sampling strata were yielded. The samples of enumeration areas (EAs) were selected independently in each stratum at two stages.

The explicit stratification and proportional allocation were achieved at each of the lower administrative levels by sorting the sampling frame within each sampling stratum before sample selection according to the administrative units in the different levels, and by using a probability proportion to size selection at the first stage of sampling. For the 2016EDHS data collection, 645 EAs were selected with a probability proportional to the EA size and with independent selection in each sampling stratum. The EA size is the number of residential households in the EA that was determined in the 2007 Ethiopian Population and Housing Census. According to the 2016 EDHS procedures, a household listing operation was implemented in the selected EAs, and the resulting lists of households served as the sampling frame for the selection of households in the second stage. The data collectors interviewed only the pre-selected households. In the EDHS, there were no replacements or changes of the pre-selected households in the implementing stages to prevent bias. All the under-five children, who were usual members of the selected households or who spent the night before the survey in the selected households were eligible for the child survey (25). After managing the missing data, 2910 respondents that had under-five children were included for this further analysis. However, the 2016EDHS data collected data from 10641 children.

Data Collection Tools And Variables

The 2016EDHS usually use five groups of questionnaires in collecting the data. Those questionnaires are the household questionnaire, the woman’s questionnaire, the man’s questionnaire, the biomarker questionnaire, and the health facility questionnaire. The questionnaires were adapted from the DHS program’s standard demographic and health survey questionnaires in a way to reflect the population and health issues relevant to the Ethiopian context. Questions that stated about children were integrated to woman’s questionnaire. The outcome variable of this study is health professional assisted KMC. The independent variables were socio-demographic variables of both children and mothers, health services provided to children and the wider community, and substance use like cigarette smoking and Khat chewing in considering the availability of the variables in the 2016EDHS data (24, 25).

Definition

KMC

Holding a small neonate (< 2000gm) in the mothers’ skin in a prone and upright position on the maternal chest that also enclosed in maternal clothing for thermal regulation (8).

Health professional assisted KMC

Practice of KMC under the HCPs initiation for mothers who gave birth in health facilities.

Data analysis

The data analysis started with a summary of socio-demographic characteristics, and other relevant factors of the respondents using descriptive statistics. Before analyzing the data, weighting, cluster and strata adjustment were performed to get representative sample and appropriate to population size estimates. A logistic regression model was used to assess the association of health professionals assisted KMC. A statistically significant association was determined at a p-value of less than 0.05.

Socio-demographic characteristics study subjects

In this study, 1040(35.7%) husbands were had agricultural jobs, and 1658(57.0%) mothers were housewife. More than fifty seven percent 1667(57.3%) of mothers were rural residents, 2867(98.5%) mothers were married, and 1036(35.6%) mothers were completed primary education. Regarding religion, 1224(42.1%) mothers were Orthodox, and 1139(39.1%) mother were unable to read and write (Table 1).

Table 1

Socio-demographic characteristics of respondents and their children in Ethiopia
Variables	Categories	Frequency(n = 2910)	Percent
Husband occupation	Do not work	398	13.7
	Professional/managerial	355	12.2
	Clerical	37	1.3
	Sales	397	13.6
	Agricultural employee	1040	35.7
	Service	181	6.2
	Skilled manual	356	12.2
	Unskilled manual	146	5.0
Maternal occupation	Do not work	1658	57.0
	Professional/managerial	118	4.1
	Clerical	38	1.3
	Sales	446	15.3
	Agricultural employee	424	14.6
	Service	67	2.3
	Skilled manual	112	3.8
	Unskilled manual	47	1.6
Head of household	Male	2350	80.8
	Female	560	19.2
Residence	Urban	1243	42.7
	Rural	1667	57.3
Maternal age	15–19	143	4.9
	20–24	718	24.7
	25–29	894	30.7
	30–34	604	20.8
	35–39	401	13.8
	40–44	124	4.3
	45–49	26	0.9
Maternal education	No education	1139	39.1
	Primary	1036	35.6
	Secondary	453	15.6
	Higher	282	9.7
Region	Tigray	484	16.6
	Afar	111	3.8
	Amhara	230	7.9
	Oromia	267	9.2
	Somali	237	8.1
	Benishangul	213	7.3
	SNNPR	322	11.1
	Gambela	199	6.8
	Harari	265	9.1
	Addis Adaba	334	11.5
	Dire-dawa	248	8.5
Religion	Orthodox	1224	42.1
	Catholic	18	0.6
	Protestant	443	15.2
	Muslim	1206	41.4
	Traditional	6	0.2
	Other	13	0.4
Wealth index	Poorest	436	15.0
	Poorer	393	13.5
	Middle	362	12.4
	Richer	397	13.6
	Richest	1322	45.4
Readiness	Wanted then	2315	79.6
	Wanted later	452	15.5
	Wanted no more	143	4.9
Cigarette smoking	No	2886	99.2
	Yes	24	0.8
Chat chewing	No	2600	89.3
	Yes	310	10.7
Type of birth	Single birth	2814	96.7
	1st of multiple	51	1.8
	2nd of multiple	45	1.5
Sex of the child	Male	1477	50.8
	Female	1433	49.2
Marital status	Married	2867	98.5
	Living with partner	43	1.5
Child size at birth	Very large	552	19.0
	Large	446	15.3
	Average	1277	43.9
	Very small	227	7.8
	Small	408	14.0

Health Professional Assisted Kmc

The coverage of health professional assisted KMC practice among mothers who gave birth in a health facilities were 1808(62.1%), 95%CI (60.3, 63.9).The others 1102(37.9%), 95%CI(36.1, 39.7) of mothers did not practiced KMC, but they gave birth in a health facilities under the support of trained health professionals.

Factors Associated With Health Professionals Assisted Kmc

On binary logistic regression analysis; wealth index, region, cigarette smoking, religion, maternal education and child size were associated with health professional assisted KMC practice. But in the final multivariable logistic regression model; only wealth index, poorest (AOR, (95%CI)), (0.60, (0.43, 0.81)), and poorer (0.62, (0.46, 0.86)) were associated with health professionals assisted KMC (Table 2).

Table 2

The association of health professionals assisted KMC practice and possible maternal, environmental, child, and households related factors in Ethiopia
Variables	Categories		HCPs assisted KMC(n = 2910)					OR				95% CI			P-
			No			Yes		COR		AOR		Lower		Upper	value
Wealth index	Poorest		216 (19.6)			220(12.2)		0.47*		0.60		0.43		0.81	0.001
	Poorer		189 (17.2)			204(11.3)		0.50*		0.62		0.46		0.86	0.001
	Medium		138 (12.5)			224(12.4)		0.76*		0.95		0.68		1.32	0.76
	Richer		139 (12.6)			258(14.3)		0.86		1.06		0.78		1.45	0.72
	Richest		420 (38.1)			902(49.9)		1		1
Residence	Rural		712 (64.6)			955(52.8)		0.61*		0.77		0.59		1.00	0.05
	Urban		390 (35.4)			853(47.2)		1		1
Head of	Male		896 (81.3)			1454(80.4)		1		1
	Female		206 (18.7)			354(19.6)		1.06		1.03		0.84		1.25	0.80
Khat chewing	No		977 (88.7)			1623(89.8)		1		1
Khat chewing	Yes		125 (11.3)			185(10.2)		0.89		0.86		0.67		1.10	0.23
Child sex	Male		576 (52.3)			901(49.8)		1		1
Child sex	Female		526 (47.7)			907(50.2)		1.10		1.06		0.91		1.24	0.43
Maternal education	No education		480 (43.6)			659(36.4)		0.70*		1.07		0.79		1.45	0.68
Maternal education	Primary		375 (34.0)			661(36.6)		0.90		1.17		0.87		1.57	0.29
		Secondary		152 (13.8)	301(16.6)		1.01		1.11		0.81		1.53			0.52
		Higher		95 (8.6)	187(10.3)		1		1
Child size at birth		Very large		223 (20.2)	329(18.2)		1		1
		Large		162 (14.7)	284(15.7)		1.19		1.16		0.89		1.50			0.28
		Average		451 (40.9)	826(45.7)		1.24*		1.22		0.99		1.51			0.06
		Small		93 (8.4)	134 (7.4)		0.98		1.03		0.75		1.42			0.85
		Very small		173 (15.7)	235(13.0)		0.92		0.96		0.74		1.25			0.76
ARDS		No		991 (89.9)	1642(90.8)		1		1
		Yes		111 (10.1)	166 (9.2)		1.11		1.03		0.81		1.03			0.85
*=p-value < 0.05

The practice of KMC in mothers who gave birth in the health facilities was 1808 (62.1%), 95% CI (60.3, 63.9). The others 1102(37.9%), 95%CI (36.1, 39.7) mothers did not practice KMC while they gave birth at health facilities. The current study’s coverage of KMC practice is higher than studies that reported 41.9% KMC (26), 46.4% KMC and 54.15% KMC (27), and 28.1% KMC (28). The difference might be as a result of study population difference, sample size difference, inclusion and exclusion criteria, and socio-demographic difference. This current study considered only mothers who followed by health professionals starting from before birth, during birth, and post-partum. However, all the referred papers included mothers who visited health facilities in post-partum irrespective of their place of birth. The present study reported a lower KMC practice than a study reported from Ghana that was 84.6% (29). This variation might be because of socio-demographic difference between Ghana and Ethiopia. In addition, the health care service provided in Ghana might be better than in Ethiopia. Furthermore Ethiopia integrated KMC to the National Strategy for Newborn and Child Survival lately in 2015/16 than Ghana that started some years before Ethiopia (30). The current study have a similar KMC practice with a study that conducted from Ghana, home based KMC practice (29), and other study that reported 61.6% (31). This also reflects the socio-demographic difference between the study areas, Ethiopia and Ghana. Because the KMC practice in the Ethiopian health facilities become equal with Ghanaians Home based KMC practice. In assessing the association of health professional assisted KMC practice and its associated factors; religion, residence, wealth index, maternal education, and birth weight were associated with health professional assisted KMC practice at binary logistic regression model. However, in the final multivariable logistic regression model; only wealth index was associated with health professional assisted KMC practice. Mothers who had poorest (AOR, (95%CI), (0.60, (0.43, 0.81) and poorer (AOR, (95%CI), (0.62, (0.46, 0.86) wealth index were more prone to lack KMC practice than mothers from richest households. However, a study from Aksum, Ethiopia reported the lack of association between neonatal care, KMC practice and wealth index (32). The difference in these studies might be as a result of study area variation. This current study derived from the 2016EDHS, in which both urban and rural areas were represented proportionally. However, the study from Aksum considers only urban dwellers that might have similar degree of economic class.

The prevalence of health professional assisted KMC practice was low, which was far lower than the expectation for mothers who gave birth in health facilities. The lowest wealth index was protective for not practicing KMC. The reason might be that mothers from higher income households might not initiate breast feeding, which might contribute for not practicing KMC. Thus, the minister of health or other researchers should study further why mothers from high income did not practicing KMC in considering the assumption of this author.

Some of the variables were excluded while managing the missing values. Due to this, the sample size was small that might compromise the inclusiveness of this research.

AOR - adjusted odds ratio; CI - confidence interval; SPSS - statistical package for social science; WHO - World Health Organization; EDHS - Ethiopian demography and health survey, DHS - Demography and health survey; SNNPR - Southern nation nationalities and people representatives; EA - Enumeration areas; USAID- The United states Agency for International Development, and ICF- Inner City Fund, KMC-Kangaroo Mother Care; LBW- low-birth weight; NMR-newborn mortality.

Ethics approval and consent to participate

This further EDHS data base analysis used a collected data from the online library by email request, DHS. Thus, the ethical issue is usually waived. The 2016 EDHS data is a reviewed and approved document by the Federal Democratic Republic of Ethiopia, Ministry of Science and Technology, and the Institutional Review Board of ICF International.

Consent for publication

Not applicable

Availability of data and materials

The data that support the conclusions of this research is already online in the DHS database online at https://www.dhsprogram.com/

Competing interests

The authors have no conflict of interests

Funding

Not applicable

Author’s contribution

For this study MWK, AMA, and KDT conceived the title and designed the study, preparing a complex data for analysis, analyzing the complex data, critically revising the work and writing the final manuscript. All the authors read and approved the final version of this manuscript. The authors agreed to be accountable for all aspects of this work.

Acknowledgments

We would like to acknowledge the central statistical agency of Ethiopia for the data (EDHS) they collected and provide it online in collaboration with the USAID. We also acknowledge the USAID for supporting the project, publishing the data online, and allow researchers to use it for free.

Bhutta ZA, Das JK, Bahl R, Lawn JE, Salam RA, Paul VK, et al. Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? Lancet. 2014;384(9940):347-70.
Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012;379(9832):2151-61.
You D, Bastian P, Wu J, Wardlaw TM, editors. Levels and trends in child mortality. Report 2012. Estimates developed by the UN Inter-agency Group for Child Mortality Estimation2012.
World Health O. Born too soon: the global action report on preterm birth. Geneva: World Health Organization; 2012.
Lunze K, Hamer DH. Thermal protection of the newborn in resource-limited environments. J Perinatol. 2012;32(5):317-24.
Howson CP, Kinney MV, McDougall L, Lawn JE. Born too soon: preterm birth matters. Reprod Health. 2013;10 Suppl 1(Suppl 1):S1.
Requejo JH, Bryce J, Barros AJ, Berman P, Bhutta Z, Chopra M, et al. Countdown to 2015 and beyond: fulfilling the health agenda for women and children. Lancet. 2015;385(9966):466-76.
Charpak N, Ruiz JG, Zupan J, Cattaneo A, Figueroa Z, Tessier R, et al. Kangaroo Mother Care: 25 years after. Acta Paediatr. 2005;94(5):514-22.
WHO Guidelines Approved by the Guidelines Review Committee. WHO Recommendations on Interventions to Improve Preterm Birth Outcomes. Geneva: World Health Organization Copyright © World Health Organization 2015.; 2015.
Lawn JE, Mwansa-Kambafwile J, Horta BL, Barros FC, Cousens S. 'Kangaroo mother care' to prevent neonatal deaths due to preterm birth complications. Int J Epidemiol. 2010;39 Suppl 1(Suppl 1):i144-54.
Heidarzadeh M, Hosseini MB, Ershadmanesh M, Gholamitabar Tabari M, Khazaee S. The Effect of Kangaroo Mother Care (KMC) on Breast Feeding at the Time of NICU Discharge. Iran Red Crescent Med J. 2013;15(4):302-6.
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):130-41j.
Institute of Medicine Committee on Understanding Premature B, Assuring Healthy O. The National Academies Collection: Reports funded by National Institutes of Health. In: Behrman RE, Butler AS, editors. Preterm Birth: Causes, Consequences, and Prevention. Washington (DC): National Academies Press (US) Copyright © 2007, National Academy of Sciences.; 2007.
Medhanyie AA, Alemu H, Asefa A, Beyene SA, Gebregizabher FA, Aziz K, et al. Kangaroo Mother Care implementation research to develop models for accelerating scale-up in India and Ethiopia: study protocol for an adequacy evaluation. BMJ Open. 2019;9(11):e025879.
World Health O. Every newborn: an action plan to end preventable deaths. Geneva: World Health Organization; 2014 2014.
Vesel L, Bergh AM, Kerber KJ, Valsangkar B, Mazia G, Moxon SG, et al. Kangaroo mother care: a multi-country analysis of health system bottlenecks and potential solutions. BMC Pregnancy Childbirth. 2015;15 Suppl 2(Suppl 2):S5.
Charpak N, Ruiz-Pelaez JG, Figueroa de CZ, Charpak Y. A randomized, controlled trial of kangaroo mother care: results of follow-up at 1 year of corrected age. Pediatrics. 2001;108(5):1072-9.
Affonso DD, Wahlberg V, Persson B. Exploration of mothers' reactions to the kangaroo method of prematurity care. Neonatal Netw. 1989;7(6):43-51.
Charpak N, Ruiz-Peláez JG, Figueroa de CZ, Charpak Y. Kangaroo mother versus traditional care for newborn infants </=2000 grams: a randomized, controlled trial. Pediatrics. 1997;100(4):682-8.
Weldearegay HG, Medhanyie AA, Abrha MW, Tadesse L, Tekle E, Yakob B, et al. Quality of Kangaroo Mother Care services in Ethiopia: Implications for policy and practice. PLoS One. 2019;14(11):e0225258.
Bergh AM, Arsalo I, Malan AF, Patrick M, Pattinson RC, Phillips N. Measuring implementation progress in kangaroo mother care. Acta Paediatr. 2005;94(8):1102-8.
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. Health SA Gesondheid. 2016;21:228-37.
Bergh AM, van Rooyen E, Pattinson RC. Scaling up kangaroo mother care in South Africa: 'on-site' versus 'off-site' educational facilitation. Hum Resour Health. 2008;6:13.
Wado YD. Women's autonomy and reproductive health-care-seeking behavior in Ethiopia. Women Health. 2018;58(7):729-43.
Gertler P. Do Conditional Cash Transfers Improve Child Health? Evidence from PROGRESA's Control Randomized Experiment. American Economic Review. 2004;94(2):336-41.
Yusuf E FF, Dulla D. Utilization of Kangaroo Mother Care (KMC) and Influencing Factors among Mothers and Care Takers of Preterm/Low Birth Weight Babies in Yirgalem Town, Southern, Ethiopia. . 2018.
Olawuyi O, Ezenwa BN, Fajolu IB, Onwuama M, Ezeaka CV. Knowledge, attitude and practice of kangaroo mother care among mothers in the neonatal wards of a tertiary care center. Pan Afr Med J. 2021;38:364.
Bedaso A, Kebede E, Adamu T. Assessment of skin-to-skin contact (SSC) during the postpartum stay and its determinant factors among mothers at public health institutions in Ethiopia. BMC Res Notes. 2019;12(1):136.
Nguah SB, Wobil PN, Obeng R, Yakubu A, Kerber KJ, Lawn JE, et al. Perception and practice of Kangaroo Mother Care after discharge from hospital in Kumasi, Ghana: a longitudinal study. BMC Pregnancy Childbirth. 2011;11:99.
Ethiopian Minister of Health Machd. Ethiopia. National Newborn and Child Survival Strategy Document Brief Summary 2015/16-2019/20. 2015.
Kassahun G. Knowledge, Attitude, Practice and Associated Factors of Kangaroo Mother Care for Neonatal Survival Among Care Takers of Preterm and Low Birth Weight Infants in Health Care Settings, Hawassa, Southern Ethiopia, 2018. Journal of Health, Medicine and Nursing. 2019.
Berhe M, Medhaniye AA, Kahsay G, Birhane E, Abay M. Essential neonatal care utilization and associated factors among mothers in public health facilities of Aksum Town, North Ethiopia, 2016. PLoS One. 2017;12(4):e0175902.

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Health professional assisted Kangaroo mother care practice in Ethiopian health care facilities: Evidence from the 2016 Ethiopian demographic and health survey

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Abstract

Background

Methodology

Data collection period, and study population

Sampling Techniques, Procedures And Study Design

Data Collection Tools And Variables

Definition

Data analysis

Results

Socio-demographic characteristics study subjects

Health Professional Assisted Kmc

Factors Associated With Health Professionals Assisted Kmc

Discussions

Conclusions

Limitations

Abbreviations

Declarations

References

Additional Declarations

Status:

Journal Publication

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