Kangaroo Mother Care in Vietnam: A National Survey of a Middle-Income Country
Abstract
:1. Introduction
2. Methods
2.1. Design
2.2. Participants
2.3. Procedures
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Hospital Level | ||||
---|---|---|---|---|
Overall Estimate: % (95% CI) | Central: % | Provincial: % (95% CI) | District: % (95% CI) | |
Routine KMC implementation: | ||||
KMC is routinely performed | 49% (40 to 57%) | 83% | 65% (59 to 72%) | 35% (25 to 45%) |
Planning to introduce KMC in the next 12 months | 14% (9 to 20%) | 17% | 19% (14 to 25%) | 11% (5 to 18%) |
KMC is not routinely performed | 37% (29 to 45%) | 0% | 16% (20 to 21%) | 54% (44 to 64%) |
Hospital Level | ||||
---|---|---|---|---|
Overall Estimate: % (95% CI) | Central: % | Provincial: % (95% CI) | District: % (95% CI) | |
Availability of written protocol for KMC | 48% (36 to 60%) | 67% | 55% (47 to 62%) | 46% (31 to 61%) |
Starting KMC is decided by: a | ||||
Doctor | 95% (90 to 100%) | 100% | 98% (95 to 100%) | 94% (88 to 100%) |
Nurse | 23% (13 to 33%) | 17% | 27% (20 to 34%) | 22% (9 to 34%) |
Midwife | 41% (29 to 52%) | 0% | 23% (16 to 29%) | 46% (31 to 61%) |
Infants usually considered eligible for KMC: a | ||||
Full-term infants | 47% (35 to 59%) | 50% | 27% (20 to 34%) | 51% (36 to 66%) |
Late preterm infants (34–36 weeks) | 84% (76 to 92%) | 67% | 77% (71 to 84%) | 86% (76 to 97%) |
Very preterm infants (≤33 weeks) | 40% (29 to 51%) | 100% | 64% (56 to 71%) | 32% (18 to 46%) |
Babies receiving CPAP | 14% (6 to 22%) | 33% | 14% (8 to 19%) | 14% (3 to 24%) |
Babies receiving continuous IV fluids | 19% (10 to 29%) | 33% | 20% (14 to 27%) | 19% (7 to 31%) |
Babies with very LBW <1.5 kg | 50% (38 to 62%) | 83% | 64% (56 to 71%) | 46% (31 to 61%) |
Babies with extremely LBW <1.2 kg | 34% (23 to 45%) | 83% | 57% (49 to 65%) | 27% (14 to 40%) |
Educational courses on KMC have been held in the hospital b | 51% (39 to 63%) | 50% | 59% (51 to 67%) | 49% (34 to 64%) |
Posters to advertise KMC in Vietnamese: | ||||
Only in postnatal ward | 28% (17 to 40%) | 17% | 14% (8 to 19%) | 32% (18 to 46%) |
Only in NICU | 7% (1 to 12%) | 0% | 14% (8 to 19%) | 5% (0 to 12%) |
In both postnatal ward and NICU | 17% (9 to 26%) | 33% | 32% (24 to 39%) | 14% (3 to 24%) |
No posters available in the hospital | 47% (35 to 59%) | 50% | 41% (33 to 49%) | 49% (33 to 64%) |
Routine presentation of KMC to parents c | 86% (78 to 95%) | 83% | 86% (81 to 92%) | 86% (76 to 97%) |
Hospital Level | ||||
---|---|---|---|---|
Overall Estimate: % (95% CI) | Central: % | Provincial: % (95% CI) | District: % (95% CI) | |
KMC is performed by: a | ||||
Only mother | 53% (42 to 65%) | 20% | 25% (18 to 32%) | 61% (46 to 75%) |
Mother and father | 32% (21 to 42%) | 60% | 50% (42 to 58%) | 26% (13 to 39%) |
Only father | 3% (0 to 7%) | 20% | 5% (1 to 8%) | 3% (0 to 7%) |
Other family members (when parents are unavailable) | 32% (22 to 42%) | 80% | 61% (54 to 69%) | 24% (11 to 36%) |
KMC is performed in: a | ||||
KMC-dedicated room b | 45% (33 to 56%) | 60% | 66% (58 to 73%) | 39% (25 to 54%) |
Mother’s room | 40% (28 to 51%) | 40% | 30% (22 to 37%) | 42% (28 to 57%) |
Neonatal intensive care unit | 15% (7 to 23%) | 80% | 16% (10 to 22%) | 13% (3 to 23%) |
Other rooms | 28% (17 to 39%) | 0% | 14% (8 to 19%) | 32% (18 to 45%) |
Temperature control in the room where KMC is performed: | ||||
Climate-controlled room c | 67% (55 to 78%) | 100% | 79% (73 to 86%) | 63% (49 to 77%) |
Depending on the season (not climate controlled) | 26% (15 to 37%) | 0% | 16% (10 to 22%) | 29% (16 to 42%) |
Unknown | 7% (0 to 13%) | 0% | 5% (1 to 8%) | 8% (0 to 16%) |
Average daily duration of SSC during KMC: | ||||
<6 h per day (0–25% of day) | 42% (31 to 54%) | 0% | 25% (18 to 32%) | 46% (33 to 62%) |
6–12 h per day (25–50% of day) | 13% (5 to 21%) | 40% | 11% (6 to 16%) | 13% (3 to 23%) |
12–18 h per day (50–75% of day) | 25% (15 to 25%) | 20% | 30% (22 to 37%) | 24% (11 to 36%) |
18–24 h per day (75–100% of day) | 9% (5 to 13%) | 40% | 32% (23 to 39%) | 3% (0 to 7%) |
Unknown | 11% (3 to 19%) | 0% | 2% (0 to 5%) | 13% (3 to 23%) |
Duration of SSC during KMC is decided by: | ||||
The mother | 15% (7 to 24%) | 0% | 14% (8 to 19%) | 16% (5 to 27%) |
Both the mother and the health care staff | 1% (0 to 2%) | 0% | 5% (1 to 8%) | NA |
The health care staff | 53% (41 to 64%) | 40% | 32% (24 to 39%) | 58% (43 to 72%) |
Specific duration based on our local protocol | 23% (14 to 32%) | 60% | 50% (42 to 58%) | 16% (5 to 27%) |
Unknown duration | 8% (1 to 16%) | 0% | NA | 11% (1 to 20%) |
Measurement of baby’s body temperature during KMC | 58% (47 to 70%) | 80% | 82% (76 to 88%) | 53% (38 to 67%) |
Number of measurements per day: | ||||
Pre-established number d | 57% (43 to 72%) | 50% | 78% (71 to 85%) | 50% (30 to 70%) |
Based on health staff decision | 34% (20 to 48%) | 50% | 17% (10 to 23%) | 40% (20 to 60%) |
Unknown | 9% (0 to 17%) | 0% | 6% (2 to 10%) | 10% (0 o 22%) |
Exclusive breastfeeding at discharge | 89% (85 to 92%) | 80% | 84% (78 to 90%) | 92% (84 to 100%) |
Early discharge for babies who received KMC: | ||||
Yes | 54% (42 to 65%) | 60% | 68% (61 to 76%) | 50% (35 to 65%) |
No | 36 (24 to 47%) | 40% | 30% (22 to 37%) | 37% (23 to 51%) |
Unknown | 11% (3 to 19%) | 0% | 2% (0 to 5%) | 1% (3 to 23%) |
Follow-up for babies who received KMC: | ||||
All babies who received KMC | 39% (28 to 51%) | 20% | 30% (22 to 37%) | 42% (28 to 57%) |
Only preterm babies who received KMC | 23% (15 to 32%) | 60% | 52% (44 to 60%) | 16% (5 to 27%) |
Sickest babies who received KMC | 1% (0 to 2%) | 20% | 5% (1 to 8%) | NA |
None | 29% (18 to 40%) | 0% | 9% (5 to 14%) | 34% (20 to 48%) |
Unspecified | 7% (1 to 13%) | 0% | 5% (1 to 8%) | 8% (0 to 16%) |
Availability of information about breastfeeding at 6 months | 44% (32 to 56%) | 40% | 32% (24 to 39%) | 47% (33 to 62%) |
Documentation on KMC in patient’s record: | ||||
Yes | 71% (60 to 81%) | 80% | 68% (61 to 76%) | 71% (58 to 84%) |
No | 23% (13 to 33%) | 20% | 32% (24 to 39%) | 21% (9 to 33%) |
Unspecified | 6% (0 to 13%) | 0% | NA | 8% (0 to 16%) |
Hospital Level | ||||
---|---|---|---|---|
Most Difficult Aspects in KMC Implementation: a | Overall Estimate: % (95% CI) | Central: % | Provincial: % (95% CI) | District: % (95% CI) |
Adequate time spent in skin-to-skin contact | 33% (24 to 41%) | 33% | 42% (35 to 49%) | 31% (22 to 41%) |
Exclusive breastfeeding | 14% (8 to 20%) | 17% | 23% (17 to 29%) | 13% (6 to 19%) |
Early discharge (whenever possible) | 7% (2 to 12%) | 0% | 4% (1 to 7%) | 8% (2 to 13%) |
Follow-up after discharge | 76% (68 to 83%) | 50% | 83% (77 to 88%) | 75% (66 to 84%) |
Importance (from 1 to 5) of strategies to implement/improve KMC: | Overall estimate: mean (95% CI) | Central: mean | Provincial: mean (95% CI) | District: mean (95% CI) |
Education of the mother | 3.3 (3.1 to 3.4) | 2.8 | 3.0 (2.9 to 3.1) | 3.3 (3.1 to 3.5) |
Education of mother and father | 4.2 (3.9 to 4.4) | 4.8 | 4.3 (4.1 to 4.4) | 4.1 (3.9 to 4.4) |
Education of doctors | 3.8 (3.6 to 4.0) | 3.7 | 3.9 (3.7 to 4.0) | 3.8 (3.6 to 4.1) |
Education of nurses | 3.3 (3.1 to 3.6) | 4.3 | 3.9 (3.7 to 4.1) | 3.3 (3.0 to 3.5) |
Education of midwifes | 3.5 (3.3 to 3.7) | 2.7 | 3.0 (2.7 to 3.2) | 3.5 (3.3 to 3.8) |
Availability of a KMC-dedicated room | 3.7 (3.5 to 3.9) | 4.7 | 3.8 (3.6 to 3.9) | 3.7 (3.4 to 4.0) |
Close follow-up after discharge | 2.6 (2.4 to 2.9) | 3.5 | 2.7 (2.5 to 2.9) | 2.6 (2.3 to 2.9) |
Improve babies/nurse or babies/midwife ratio | 2.3 (2.1 to 2.5) | 3 | 2.2 (2.0 to 2.3) | 2.3 (1.2 to 2.5) |
Written protocol on KMC | 3.0 (2.8 to 3.2) | 3 | 3.0 (2.8 to 3.2) | 3.0 (2.7 to 3.2) |
Lack of other equipment | 3.3 (3.1 to 3.5) | 3.7 | 3.2 (3.0 to 3.4) | 3.3 (3.0 to 3.5) |
Lack of temperature control during summer | 3.1 (2.9 to 3.3) | 3.2 | 3.2 (3.0 to 3.3) | 3.1 (2.9 to 3.3) |
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Cavallin, F.; Trevisanuto, D.; Tiep, T.V.; Diep, N.T.N.; Hao, V.T.; Ngan, D.T.; Thuy, N.T.; Hoi, N.T.X.; Moccia, L. Kangaroo Mother Care in Vietnam: A National Survey of a Middle-Income Country. Children 2022, 9, 1667. https://doi.org/10.3390/children9111667
Cavallin F, Trevisanuto D, Tiep TV, Diep NTN, Hao VT, Ngan DT, Thuy NT, Hoi NTX, Moccia L. Kangaroo Mother Care in Vietnam: A National Survey of a Middle-Income Country. Children. 2022; 9(11):1667. https://doi.org/10.3390/children9111667
Chicago/Turabian StyleCavallin, Francesco, Daniele Trevisanuto, Tran Viet Tiep, Nguyen Thi Ngoc Diep, Vuong Thi Hao, Doan Thi Ngan, Nguyen Thi Thuy, Nguyen Thi Xuan Hoi, and Luciano Moccia. 2022. "Kangaroo Mother Care in Vietnam: A National Survey of a Middle-Income Country" Children 9, no. 11: 1667. https://doi.org/10.3390/children9111667