AIM : To measure progress with the implementation of
kangaroo mother care (KMC) for low birth-weight
(LBW) infants at a health systems level.
DESIGN : Action research design, with district and regional
hospitals as the unit of analysis.
SETTING : Four regions in Ghana, identified by the Ghana
Health Service and UNICEF.
PARTICIPANTS : Health workers and officials, health care
facilities and districts in the four regions.
INTERVENTION : A one-year implementation programme
with three phases: (1) introduction to KMC, skills development
in KMC practice and the management of
implementation; (2) advanced skills development for
regional steering committee members; and (3) an assessment
of progress at the end of the intervention.
MAIN OUTCOME MEASURES : Description of practices,
services and facilities for KMC and the identification
of strengths and challenges.
RESULTS : Twenty-six of 38 hospitals (68%) demonstrated
sufficient progress with KMC implementation. Half
of the hospitals had designated a special ward for
KMC. 66% of hospitals used a special record for infants
receiving KMC. Two of the main challenges were
lack of support for mothers who had to remain with
their LBW infants in hospital and no follow-up review
services for LBW infants in 39% of hospitals.
CONCLUSIONS : It was possible to roll out KMC in Ghana,
but further support for the regions is needed to maintain the momentum. Lessons learned from this
project could inform further scale-up of KMC and other
projects in Ghana.