FACTORS INFLUENCING WEIGHT GAIN AMONG LOW BIRTHWEIGHT NEONATES UNDER KANGAROO MOTHER CARE IN THE LAKE BASIN ECONOMIC BLOCK, KENYA.

Abstract

Kangaroo Mother Care (KMC) is a beneficial method for bonding, breast-feeding and temperature control of all neonates, regardless of weight, gestational age and clinical condition. In low-income neonatal units, the method is used 24 hours a day (continuous KMC), but in affluent settings with high tech equipment (incubator use), the method is usually implemented as shorter sessions (intermittent KMC). It was recommended that midwives initiate continuous KMC, even in a high tech-unit, as soon as possible after the infant is born and after initial resuscitation and stabilization. In Western Kenya, (Busia, Kisii and Migori Counties), were selected due to their high burden of neonatal mortality associated with low-birth-weight neonates. The KMC practice outcomes were not well elaborated yet there was an increasing trend of low birthweight neonates (birth weight below 2500gm), Busia County 20% -30%, Kisii 15.9%-20%, and Migori at 16% in the period 2018 to 2020 respectively. There was limited systemic information available on the outcomes of KMC practice. This was a mixed-method research design that examined maternal, midwife and facility related factors that influenced outcomes of KMC in Western Kenya (Busia, Kisii and Migori). Data was collected through semi-structured, pretested interviewer administered questionnaires. Quantitative data was analyzed using SPSS version 26. Bivariate and multivariate logistic regression analysis identified significant predictors of KMC utilization. Variables with P< 0.05 in bivariate analysis was included in multivariate models, results were reported using Adjusted Odds Ratios and 95% CI. The study involved a representative sample size of 275 mothers of low-birth-weight neonates, that was determined through power analysis, of mothers and midwives in the three counties. Ethical approval was secured, and participants were provided with informed consent before data collection. Qualitative data was analyzed thematically to explore contextual barriers and enablers to achieving better KMC outcomes. The study findings generated evidence-based recommendations for strengthening KMC practices, informed policy adjustments and enhancing community health education in Western Kenya. The study aims to determine the mother, health facility and midwife factors and their influence on weight gain among neonates as the key indicator of KMC outcomes.