Helping small babies survive: an evaluation of facility-based Kangaroo Mother Care implementation progress in Uganda

Abstract

Introduction: Prematurity is the leading cause of newborn death in Uganda, accounting for 38% of the nation's 39,000 annual newborn deaths. Kangaroo mother care is a high-impact; cost-effective  intervention that has been prioritized in policy in Uganda but implementation has been limited.

Methods: A standardised, cross-sectional, mixed-method evaluation design was used, employing  semi-structured key-informant interviews and observations in 11 health care facilities implementing kangaroo mother care in Uganda.

Results: The facilities visited scored between 8.28 and 21.72 out of the possible 30 points with a median  score of 14.71. Two of the 3 highest scoring hospitals were private, not-for-profit hospitals whereas the second highest scoring hospital was a central teaching hospital. Facilities with KMC services are not  equally distributed throughout the country. Only 4 regions (Central 1, Central 2, East-Central and Southwest) plus the City of Kampala were identified as having facilities providing KMC services.

Conclusion: KMC services are not instituted with consistent levels of quality and are often dependent on  private partner support. With increasing attention globally and in country, Uganda is in a unique position  to accelerate access to and quality of health services for small babies across the country.

Key words: Delivery of health care, implementation, infant premature, Kangaroo Mother Care, neonatal, newborn, preterm, program evaluation, Uganda