Mothers’ perceptions of the practice of kangaroo mother care for preterm neonates in sub-Saharan Africa

Background: Kangaroo Mother Care (KMC) requires few specialized resources, reduces mortality, and can be implemented in low resource environments. It is now recommended for implementation around the globe. Objectives: This paper discusses KMC use with low birth weight newborns at a Tanzania hospital providing valuable outcomes assessment of KMC use in rural areas of sub-Saharan Africa. Methods: The research used retrospective records (136 Low Birth Weight (LBW) and 33 Very Low Birth Weight (VLBW) ne- onates) supplemented by observations. Data included weights (longitudinal), survival period, and cause of death if it occurred. This hospital’s KMC use and study data began when the mother-baby dyad was referred, usually birth day. Results: This KMC group demonstrated 70% survival, but 77% of deaths occur within 24 hours. After the first 24 hours, KMC survival rate was 92%. Even VLBW neonates (<1000 g) had 37.5% survival among the KMC program. Prematurity and respi- ratory distress caused nearly half of the deaths, but hypothermia (19% of deaths) and infection were factors also. Conclusion: Our study indicates the value of KMC in rural low resource environments. Results are comparable to KMC pro- grams in urban areas where newborns begin KMC after stabilization and better than outcomes reported for comparable popu- lations not practicing KMC in rural sub-Saharan Africa. Keywords: Kangaroo mother care; low birth weight; neonatal mortality; premature infant.

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Barriers and facilitators of facility-based kangaroo mother care in sub-Saharan Africa: a systematic review

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03646-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mai-Lei Woo Kinshella ◽

Tamanda Hiwa ◽

Kelly Pickerill ◽

Marianne Vidler ◽

Queen Dube ◽

...

Keyword(s):

Health Systems ◽

Health Workers ◽

Kangaroo Mother Care ◽

Health Facilities ◽

Assessment Tools ◽

Barriers And Facilitators ◽

Sub Saharan Africa ◽

Care Practice ◽

The World ◽

Sub Saharan

Abstract Background Hospital-based kangaroo mother care can help reduce preventable newborn deaths and has been recommended by the World Health Organization in the care of low birthweight babies weighing 2000 g or less. However, implementation has been limited. The objective of this review is to understand the barriers and facilitators of kangaroo mother care implementation in health facilities in sub-Saharan Africa, where there are the highest rates of neonatal mortality in the world. Methods A systematic search was performed on MEDLINE, Web of Science, Cumulative Index to Nursing and Allied Health, African Journals Online, African Index Medicus as well as the references of relevant articles. Inclusion criteria included primary research, facility-based kangaroo mother care in sub-Saharan Africa. Studies were assessed by the Critical Appraisal Skills Programme Qualitative Checklist and the National Institutes of Health quality assessment tools and underwent narrative synthesis. Results Thirty studies were included in the review. This review examined barriers and facilitators to kangaroo mother care practice at health systems level, health worker experiences and perspectives of mothers and their families. Strong local leadership was essential to overcome barriers of inadequate space, limited budget for supplies, inadequate staffing, lack of guidelines and policies and insufficient supportive supervision. Workload burdens, knowledge gaps and staff attitudes were highlighted as challenges at health workers’ level, which could be supported by sharing of best practices and success stories. Support for mothers and their families was also identified as a gap. Conclusion Building momentum for kangaroo mother care in health facilities in sub-Saharan Africa continues to be a challenge. Strengthening health systems and communication, prioritizing preterm infant care in public health strategies and supporting health workers and mothers and their families as partners in care are important to scale up. This will support sustainable kangaroo mother care implementation as well as strengthen quality of newborn care overall. PROSPERO registration: CRD42020166742.

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RTS,S/AS01, a vaccine targeting pre-erythrocytic stages of Plasmodium falciparum

Emerging Topics in Life Sciences ◽

10.1042/etls20170101 ◽

2017 ◽

Vol 1 (6) ◽

pp. 533-537

Author(s):

Lorenz von Seidlein ◽

Borimas Hanboonkunupakarn ◽

Podjanee Jittmala ◽

Sasithon Pukrittayakamee

Keyword(s):

Protective Efficacy ◽

Age Groups ◽

Sub Saharan Africa ◽

Phase Iii ◽

European Medicines Agency ◽

Older Children ◽

Pivotal Phase ◽

Malaria Epidemiology ◽

Maximum Benefit ◽

Sub Saharan

RTS,S/AS01 is the most advanced vaccine to prevent malaria. It is safe and moderately effective. A large pivotal phase III trial in over 15 000 young children in sub-Saharan Africa completed in 2014 showed that the vaccine could protect around one-third of children (aged 5–17 months) and one-fourth of infants (aged 6–12 weeks) from uncomplicated falciparum malaria. The European Medicines Agency approved licensing and programmatic roll-out of the RTSS vaccine in malaria endemic countries in sub-Saharan Africa. WHO is planning further studies in a large Malaria Vaccine Implementation Programme, in more than 400 000 young African children. With the changing malaria epidemiology in Africa resulting in older children at risk, alternative modes of employment are under evaluation, for example the use of RTS,S/AS01 in older children as part of seasonal malaria prophylaxis. Another strategy is combining mass drug administrations with mass vaccine campaigns for all age groups in regional malaria elimination campaigns. A phase II trial is ongoing to evaluate the safety and immunogenicity of the RTSS in combination with antimalarial drugs in Thailand. Such novel approaches aim to extract the maximum benefit from the well-documented, short-lasting protective efficacy of RTS,S/AS01.

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Mortality and Society in Sub-Saharan Africa

Population Studies ◽

10.1080/0032472031000147416 ◽

1993 ◽

Vol 47 (3) ◽

pp. 555-556

Author(s):

Lado Ruzicka

Keyword(s):

Sub Saharan Africa ◽

Sub Saharan

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Sub-Saharan Africa

The Military Balance ◽

10.1080/04597228708459635 ◽

1987 ◽

Vol 87 (1) ◽

pp. 118-142

Keyword(s):

Sub Saharan Africa ◽

Sub Saharan

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Adolescent Suicidality as Seen in Rural Northeastern Uganda

Crisis ◽

10.1027/0227-5910/a000059 ◽

2011 ◽

Vol 32 (1) ◽

pp. 43-51 ◽

Cited By ~ 17

Author(s):

Eugene Kinyanda ◽

Ruth Kizza ◽

Jonathan Levin ◽

Sheila Ndyanabangi ◽

Catherine Abbo

Keyword(s):

Low Socioeconomic Status ◽

Sub Saharan Africa ◽

Psychosocial Risk ◽

Psychiatric Nurses ◽

Health Concern ◽

Cross Sectional ◽

Childhood Experiences ◽

Low Socioeconomic ◽

Dsm Iv ◽

Sub Saharan

Background: Suicidal behavior in adolescence is a public health concern and has serious consequences for adolescents and their families. There is, however, a paucity of data on this subject from sub-Saharan Africa, hence the need for this study. Aims: A cross-sectional multistage survey to investigate adolescent suicidality among other things was undertaken in rural northeastern Uganda. Methods: A structured protocol administered by trained psychiatric nurses collected information on sociodemographics, mental disorders (DSM-IV criteria), and psychological and psychosocial risk factors for children aged 3–19 years (N = 1492). For the purposes of this paper, an analysis of a subsample of adolescents (aged 10–19 years; n = 897) was undertaken. Results: Lifetime suicidality in this study was 6.1% (95% CI, 4.6%–7.9%). Conclusions: Factors significantly associated with suicidality included mental disorder, the ecological factor district of residence, factors suggestive of low socioeconomic status, and disadvantaged childhood experiences.

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