Midwives' Support and Its Influence on Weight Gain for Neonates Under Kangaroo Mother Care in Western Kenya

Abstract

Context: The World Health Organization strongly recommends Kangaroo Mother Care due to its favorable effects on reducing mortality among low-birth-weight neonates weighing less than 2500 grams. This nursing procedure has been approved as a therapeutic intervention due to a lack of incubators. Midwives are strongly encouraged to focus on developing the skill while adopting a functional approach to enhance the overall well-being of neonates with low birth weight.

Aim: The study aims to examine midwives’ support and its influence on weight gain among neonates undergoing Kangaroo Mother Care in the Western Kenya sample region.

Methods: The study used an analytical cross-sectional design. This design combined both qualitative and quantitative methods to examine midwives' support and its influence on KMC outcomes in Western Kenya. A multi-stage sampling approach was applied to select 275 mothers of low-birth-weight neonates enrolled in KMC in Busia, Kisii, and Migori counties. Data were collected using structured questionnaires for mothers and 12 key informant interviews (KIIs) for midwives. Quantitative data were analyzed using SPSS version 26, and binary logistic regression was employed to assess the effect of midwives' support on neonatal weight gain, with a significance level set at p ≤0.05. Thematic analysis of qualitative data from the 12 KIIs provided additional insights into how midwives’ support influences KMC outcomes.

Results: The timing of Kangaroo Mother Care initiation significantly influenced weight-gain criteria (ꭓ²=46.89, p<0.0001), with immediate initiation associated with better outcomes. Maternal satisfaction with KMC strongly correlated with meeting weight gain (ꭓ²=43.72, p<0.0001). Support from midwives (OR 2.47, p=0.001) and midwives' knowledge (χ²=36.84, p<0.0001), as well as timely feedback on the neonate's progress (OR =3.92, p=0.0001), were also associated with meeting daily weight gain targets. The midwives described their roles in supporting KMC and influencing weight gain: "As a midwife in the KMC unit, I provide direct care to the mother and the neonate, ensuring early initiation, proper positioning, immediate and continuous breastfeeding." This support influenced weight gain.

Conclusion: The assistance of midwives is essential to maximize the benefits of KMC, particularly by supporting the timely initiation of KMC in low-birthweight neonates, providing knowledge about KMC to enable them to educate mothers, and advocating for their needs. The hospital administration should identify opportunities to strengthen KMC implementation and improve neonatal health outcomes by continuously updating midwives on current KMC practice.